There are 7000 kinds of apples in this world with diverse properties. Although the nutrient content of each different type of apple but so far scientists know the content of the fruit's potassium or potassium can prevent stroke, reduce blood sugar and blood cholesterol.
Most people consume apples directly so saja.ada also like to process them into juice, syrup or extra flavorings. There is also a processing apples into vinegar. Apple cider vinegar is the best source of soluble fiber, which do not contain cholesterol, fat and sodium.
The content of pectin effectively reduces bad cholesterol plugs blood vessels and increase levels of good cholesterol, thereby reducing the risk of heart disease.
As a good source of fiber, apples are an excellent snack for people who are losing weight, so as to prevent the hunger that comes more quickly.
For women, the birth of boron in apples shown to help women maintain hormone levels of estrogen at menopause. Maintaining estrogen means to reduce interference caused by hormone imbalance dikala menopause, such bur he blood circulation and prevent obesity and improve stamina.sts of heat, pain, depression, heart disease, osteoporosis.
Apples also protects the body from the flu virus and prevent tooth decay periodontal useful.
Wednesday, December 29, 2010
Monday, December 27, 2010
effects of cigarette consumption
Smoked has been the normal matter was encountered by us everywhere in the world. This habit has been so wide was carried out both in the educated environment high and educated low. Smoked has become the complex problem that was related to the psychological aspect and the social sign. Many researches were carried out and were even realised that smoked disrupted the health of the body. But to stop this activity really was difficult. Smoked especially could cause the illness kardiovaskuler and cancer, good lung cancer, oesophagus, laryng, and the cavity in the mouth. Cancer in the cavity in the mouth usually is begun with the existence of the irritation from cigarettes products that were burnt and sucked. This irritation caused lesi white that was not sick. Moreover smoked also could cause cavity deviations in the mouth for example to the tongue, gums, the mouth mucosa, teeth and the ceiling that take the form of stomatitis nikotina and the fungus infection.
The cigarette smoke contained components and substances that were dangerous for the body. The number of components depended on the type of tobacco, the temperature of the burning, long cigarettes, the porosity of wrapping paper, the cigarettes spice as well as was not him the filter. Whereas dangerous substances took the form of gases and particles. The cigarette smoke that was sucked by us 90% contained various gas like N2, O2, CO2, 10% the rest of them contained the certain particle like tar, Nicotine et cetera. The particle in the cigarette smoke that could cause The cigarette smoke contained components and substances that were dangerous for the body. The number of components depended on the type of tobacco, the temperature of the burning, long cigarettes, the porosity of wrapping paper, the cigarettes spice as well as was not him the filter. Whereas dangerous substances took the form of gases and particles. The cigarette smoke that was sucked by us 90% contained various gas like N2, O2, CO2, 10% the rest of them contained the certain particle like tar, Nicotine et cetera. The particle in the cigarette smoke that could cause The cigarette smoke contained components and substances that were dangerous for the body. The number of components depended on the type of tobacco, the temperature of the burning, long cigarettes, the porosity of wrapping paper, the cigarettes spice as well as was not him the filter. Whereas dangerous substances took the form of gases and particles. The cigarette smoke that was sucked by us 90% contained various gas like N2, O2, CO2, 10% the rest of them contained the certain particle like tar, Nicotine et cetera. The particle in the cigarette smoke that could cause of cancer.
The cigarette smoke contained components and substances that were dangerous for the body. The number of components depended on the type of tobacco, the temperature of the burning, long cigarettes, the porosity of wrapping paper, the cigarettes spice as well as was not him the filter. Whereas dangerous substances took the form of gases and particles. The cigarette smoke that was sucked by us 90% contained various gas like N2, O2, CO2, 10% the rest of them contained the certain particle like tar, Nicotine et cetera. The particle in the cigarette smoke that could cause The cigarette smoke contained components and substances that were dangerous for the body. The number of components depended on the type of tobacco, the temperature of the burning, long cigarettes, the porosity of wrapping paper, the cigarettes spice as well as was not him the filter. Whereas dangerous substances took the form of gases and particles. The cigarette smoke that was sucked by us 90% contained various gas like N2, O2, CO2, 10% the rest of them contained the certain particle like tar, Nicotine et cetera. The particle in the cigarette smoke that could cause The cigarette smoke contained components and substances that were dangerous for the body. The number of components depended on the type of tobacco, the temperature of the burning, long cigarettes, the porosity of wrapping paper, the cigarettes spice as well as was not him the filter. Whereas dangerous substances took the form of gases and particles. The cigarette smoke that was sucked by us 90% contained various gas like N2, O2, CO2, 10% the rest of them contained the certain particle like tar, Nicotine et cetera. The particle in the cigarette smoke that could cause of cancer.
The alternative METHOD to CANCER MEDICAL TREATMENT
Combined the traditional method and modern technology, Cryosurgery became the alternative method of taming cancer. This method also did not need the cost that was not too expensive. The medical world continued to work hard to tame cancer. Various technology were then applied for this deadly illness recuperation. One of them was cryosurgery. Cancer was still becoming the spectre was most frightening. Moreover this illness could also attack everyone, and all the age groups. Indeed the person was above 40 years old had the bigger risk when being compared by the age beneath it. Cancer was the illness that was caused by the growth of the abnormal cell. Generally cancer was not reduced, but had several kinds genetically could be dropped off.
The cause of cancer until this was not yet known definitely. However, there were several factor that it was suspected could increase the risk of the occurrence of cancer. For example like the chemical, like tar to cigarettes, the industrial chemical, the excessive illumination, and several certain viruses (the virus papiloma to humankind). The other trigger factor including giving of the excessive hormone and ransangan took the form of the collision or the friction in one of the body parts in an occurring manner for a long time. The pattern ate that was unhealthy like consumption of food berpengawet and contained colouring agent it was warned could increase the risk of the occurrence of cancer.
Cryosurgery was therapy that combined the traditional and modern method in cancer recuperation. The traditional method that was meant adalh used ice. Medical treatment has with this ice been since 3500 years ago. Ice was used to treat the wound foot, the fracture, and various wounds and the accident.
Sementara pengobatan modern adalah dengan menggunakan cairan nitrogen. Pada tahun 1960-an, cairan nitrogen digunakan untuk mengobati kanker hati dan prostat. Kedua metode pengobatan tersebut lantas digabungkan dalam metode cryosusgery ini.
The cancer cell will die or was damaged in the temperature 40 Celsius levels because of the process of the freezing and the liquefaction of the tumour in there. This broken cancer cell could happen to two methods, that is the fast method and the slow method. The fast method because of the effect of the cooler and the liquid earlier happened denaturasi protein and the membrane of the cancer cell that will cause broke out or destruction of the cancer cell. Or by means of slow, as a result of having blood vessels that experienced damage, like agregasi trombosit. Cryosurgery this could be used for all the cancer kinds, especially prostate cancer, liver cancer, and lung cancer
The cause of cancer until this was not yet known definitely. However, there were several factor that it was suspected could increase the risk of the occurrence of cancer. For example like the chemical, like tar to cigarettes, the industrial chemical, the excessive illumination, and several certain viruses (the virus papiloma to humankind). The other trigger factor including giving of the excessive hormone and ransangan took the form of the collision or the friction in one of the body parts in an occurring manner for a long time. The pattern ate that was unhealthy like consumption of food berpengawet and contained colouring agent it was warned could increase the risk of the occurrence of cancer.
Cryosurgery was therapy that combined the traditional and modern method in cancer recuperation. The traditional method that was meant adalh used ice. Medical treatment has with this ice been since 3500 years ago. Ice was used to treat the wound foot, the fracture, and various wounds and the accident.
Sementara pengobatan modern adalah dengan menggunakan cairan nitrogen. Pada tahun 1960-an, cairan nitrogen digunakan untuk mengobati kanker hati dan prostat. Kedua metode pengobatan tersebut lantas digabungkan dalam metode cryosusgery ini.
The cancer cell will die or was damaged in the temperature 40 Celsius levels because of the process of the freezing and the liquefaction of the tumour in there. This broken cancer cell could happen to two methods, that is the fast method and the slow method. The fast method because of the effect of the cooler and the liquid earlier happened denaturasi protein and the membrane of the cancer cell that will cause broke out or destruction of the cancer cell. Or by means of slow, as a result of having blood vessels that experienced damage, like agregasi trombosit. Cryosurgery this could be used for all the cancer kinds, especially prostate cancer, liver cancer, and lung cancer
Apples to cure the diabetes illness
Several diabetes kinds evidently could be cured, by means of eating apples every day, for approximately 3-4 months. The available content in functioning apples to return the function of the pancreas to produce insulin. In the case of diabetes, the achievement of the pancreas was disrupted and could not produce insulin well (not did not produce completely). For that was lazy or did not like to eat apples, could be replaced by drinking the apples vinegar (apple cidder) in an orderly fashion. This apples vinegar usually is available in self-service and pharmacies. Eat apples by means of digested more was suggested because in the process digested stimulasion of several glands in the area of the mouth happened. For that still was healthy, to avoid diabetes, improved the pattern of eating, especially should not eat food or the drink/syrup that contained the artificial sweetener, because precisely this artificial sweetener that triggered damage to the pancreas, whereas consuming the natural sweetener (cane sugar, etc.) had the level of the smaller risk. This information I the coating from various sources and the experience from several people who underwent this medical treatment, it is hoped was useful for anyone who read him.
Overcame premature ejaculation
the sexual obstacle that quite often was experienced by the men apart from dysfunction ereksi was the premature ejaculation. Was not ready in having sexual relationship, became wrong his cause factor. It is not surprising, if often was male that did not realise if he experienced the premature ejaculation. "Had sexual relationship that needed readiness." Not only the physical matter but also bounced. The premature ejaculation because of the man was not ready to face sexual relations. Because this illness was linked with the nervous system. To parents, generally because his nerves capacity to control the ejaculation was disrupted, said Dr Dr A Wardihan Sinrang, Ms to the Dawn in his office in the Unhas Rectorate, on Wednesday June 14. The man usually did not understand and only complained concerning the problem of the too fast ejaculation. In fact, that has been the sexual disturbance. Basically, the man that the premature ejaculation, could ereksi and carried out sexual relations but yes that earlier, too fast the ejaculation (reached the peak and issued sperm). The premature ejaculation, said Wardihan, was the inability to control the ejaculation so as to happen in a short time, that was not in accordance with his wish. Even was that the ejaculation, in fact penis could not penetration in the vagina. In dysfunction ereksi, sexual relations could not take place because ereksi was disturbed. Although being connected, but ereksi was still being lost. There were several theories of the cause of the premature ejaculation. Firstly, the habit achieved orgasm and the ejaculation
Tuesday, December 14, 2010
FAIL ACUTE BREATH
FAIL ACUTE BREATH
Acute respiratory failure is the failure of gas exchange in the lung, marked by the downs in arterial oxygen levels (hypoxemia) or rising levels of carbon dioxide (hypercarbia) or a combination thereof.
criteria for diagnosis in patients who breathe the air in the room get the results of blood gas analysis:
1. PaO2 less than 60 mmHg
2. PaCO2 more than 49 mmHg without any disruption of primary metabolic alkalosis
ETIOLOGY OF BREATH FAIL ACUTE DISEASE
respiratory failure can be caused by a wide - range of both acute and chronic diseases that become acute again (acute on chronic). Acute respiratory failure can also arise from chronic lung disease, especially chronic obstructive pulmonary disease (PPOM or chronic obstructive pulmonary disease), which became acute again (acute on chronic respiratory failure).
in this case causes obstruction of breath in hypersecretion, mucosal edema and bronchi spasms. bronchi spasm frequently occurs in asthma. Chronic bronchitis can develop into emphysema. spasm of the bronchi in asthma can be caused by immunological reactions, substances such as smoke, dust, cold air can also induce bronchial spasm, substances such as serotonin, histamine can cause spasm of the bronchi directly. in emphysema is characterized by changes in the anatomy of the lungs in the form of excessive inflation in the distal space and bronkhiolus terminalis, alveolar capillary membrane damage resulting in a progressive, also damage the walls of the alveoli so it can happen collapse of the alveoli - tiny alveoli during expiration.
2 forms of the disorder known as follows:
1.bronchitis "blue Bloater"
damage mainly in the airway, in addition to hypoxemia also arise in the
accompanied hypercarbia due to chronic CO2 retention, this led to stimulation of
the respiratory center is no longer the state of hypercarbia (hypercarbic drive)
but by the state of hypoxia (hypoxic drive) and the respiratory center becomes
very sensitive to the drug - drugs such as narcotics mendepresi breath central
also to the high oxygen concentration.
2.emphysema "pink puffer" here mainly in the form of emphysema lung damage PaCO2
usually not too high, failed to breath more easily overcome this type.
Monday, December 13, 2010
PATHOPHYSIOLOGY of INTRA CEREBRAL HEMATOMA
PROCESS MAY (Pathophysiology) INTRA Cerebral hematoma
Intracerebral hemorrhage is usually caused by head trauma. Bleeding is due to arterial or venous bleeding in the brain, bleeding walk slowly - the land so that symptoms that occur too slowly, intracerebral hemorrhage is more common in the area before the cases were diagnosed and evaluated early so prognosanya recovery will occur which is usually good.
With intracerebral hemorrhage have an accompanying picture is a history of head trauma, signs and symptoms appear in people depending on size and location of bleeding in the brain. Sign of increased intra kronial pressure showed a large bleeding and suppress vital structures of the brain. Bleeding that occurred in temporal areas can be dangerous because of potential side effects of lateral herniation.
Intra-cerebral hemorrhage caused by hemorrhagic stroke occurs when a blood vessel in the brain ruptures causing ischemia (reduced flow) and hypoxia on the downstream. Causes of hemorrhagic stroke include hypertension, rupture of the arteria venosa malforasi aneurysm or abnormal relationships
Intracerebral hemorrhage is usually caused by head trauma. Bleeding is due to arterial or venous bleeding in the brain, bleeding walk slowly - the land so that symptoms that occur too slowly, intracerebral hemorrhage is more common in the area before the cases were diagnosed and evaluated early so prognosanya recovery will occur which is usually good.
With intracerebral hemorrhage have an accompanying picture is a history of head trauma, signs and symptoms appear in people depending on size and location of bleeding in the brain. Sign of increased intra kronial pressure showed a large bleeding and suppress vital structures of the brain. Bleeding that occurred in temporal areas can be dangerous because of potential side effects of lateral herniation.
Intra-cerebral hemorrhage caused by hemorrhagic stroke occurs when a blood vessel in the brain ruptures causing ischemia (reduced flow) and hypoxia on the downstream. Causes of hemorrhagic stroke include hypertension, rupture of the arteria venosa malforasi aneurysm or abnormal relationships
Clinical manifestations of INTRA CEREBRAL HEMATOMA
Clinical manifestations of cerebral hematoma INTRA
1. When the hematoma enlarges sufficiently to suppress hemister cerebri, decreased consciousness occur gradually - gradually develops into a coma and death if the bleeding is not excluded
2. When the decreased level of consciousness, pupillary dilatation in these lesions have occurred hemiplegic and contralateral.
3. In an emergency can happen sensory disorders.
In intra-cerebral hemorrhage, due process demanded space will be an increase in intra-cranial pressure.
EXAMINATION SUPPORT
1. CT. Scan head which is the choice procedure to diagnose the bleeding.
2. angiography may be used if the procedure CT.Scan no result.
TREATMENT FOR PATIENTS intra cerebral hematoma
Patients with intra cerebral hematoma requiring intensive care and need to be dealt with:
1. Oxygen examination.
2. Ensure airway
3. Hemostatika
4. Anti cerebral edema (koralkosteroid, deuretik)
5. Stimulant SPP (nicholin)
6. Anticonvulsants (Dilantin, Valium)
7. Antibiotics for the prevention or treatment of infection
8. handling of the complications that occur
9. Pemdahan surgery for cases such as hematoma, aneurysm, ateria malformations, venous and others - others.
1. When the hematoma enlarges sufficiently to suppress hemister cerebri, decreased consciousness occur gradually - gradually develops into a coma and death if the bleeding is not excluded
2. When the decreased level of consciousness, pupillary dilatation in these lesions have occurred hemiplegic and contralateral.
3. In an emergency can happen sensory disorders.
In intra-cerebral hemorrhage, due process demanded space will be an increase in intra-cranial pressure.
EXAMINATION SUPPORT
1. CT. Scan head which is the choice procedure to diagnose the bleeding.
2. angiography may be used if the procedure CT.Scan no result.
TREATMENT FOR PATIENTS intra cerebral hematoma
Patients with intra cerebral hematoma requiring intensive care and need to be dealt with:
1. Oxygen examination.
2. Ensure airway
3. Hemostatika
4. Anti cerebral edema (koralkosteroid, deuretik)
5. Stimulant SPP (nicholin)
6. Anticonvulsants (Dilantin, Valium)
7. Antibiotics for the prevention or treatment of infection
8. handling of the complications that occur
9. Pemdahan surgery for cases such as hematoma, aneurysm, ateria malformations, venous and others - others.
NURSING DIAGNOSIS WHICH MAY OCCUR IN PATIENTS WITH DISEASE intra cerebral hematoma
NURSING DIAGNOSIS WHICH MAY OCCUR IN PATIENTS WITH DISEASE intra cerebral hematoma
1. Cerebral tissue perfusion changes associated with cerebral edema.
2. Ineffective breathing pattern related to damage neurovaskuler.
3. Changes in sensory perception associated with neurological deficits.
4. pikier process changes associated with physiological changes.
5. Damage to physical mobility related to immobilization.
6. Risk of infection associated with invasive procedures.
7. Nutrition less than body requirements related to hyper metabolic status.
8. High risk associated with changes in the process of family crisis transition situations.
9. lack the knowledge to know the prognosis and treatment needs related to not knowing the source of information.
1. Cerebral tissue perfusion changes associated with cerebral edema.
2. Ineffective breathing pattern related to damage neurovaskuler.
3. Changes in sensory perception associated with neurological deficits.
4. pikier process changes associated with physiological changes.
5. Damage to physical mobility related to immobilization.
6. Risk of infection associated with invasive procedures.
7. Nutrition less than body requirements related to hyper metabolic status.
8. High risk associated with changes in the process of family crisis transition situations.
9. lack the knowledge to know the prognosis and treatment needs related to not knowing the source of information.
THE CAUSE OF INTRA-CEREBRAL HEMATOMA INCLUDE:
THE CAUSE OF INTRA-CEREBRAL HEMATOMA INCLUDE:
a. Hypertension
b. Cerebral aneurysm
c. Angioma malformations arterio - venus
d. Trauma
e. Blood disease
f. Encephalitis
g. Primary or metastatic brain tumor
h. Emboliu septic
i. Hernia septic
j. Bleeding from the spinal
a. Hypertension
b. Cerebral aneurysm
c. Angioma malformations arterio - venus
d. Trauma
e. Blood disease
f. Encephalitis
g. Primary or metastatic brain tumor
h. Emboliu septic
i. Hernia septic
j. Bleeding from the spinal
INTRA CEREBRAL HEMATOMA
Bleeding that arriveds in the brain tissue is a form that destroy the hemorrhagic stroke and can occur at any age. Various - kind of spontaneous bleeding in the brain and are generally multi-factorial.
Various forms of congenital and are present in cardiovascular disease is the most common causal mechanism, but similar structures can also occur from complications of primary and secondary brain tumors, inflammation and autoimmune diseases of the brain, brain trauma, or a manifestation of systemic disease that causes hypertension.
Intra cerebral hematoma is a hematoma caused by bleeding in the cerebral cortex is usually most common in temporal lobe, followed in the frontal, parietal, and sometimes on sereblum.
This bleeding usually comes from the artery, so that very quickly entered into the ventrical and pressing the brain stem as well as others.
Various forms of congenital and are present in cardiovascular disease is the most common causal mechanism, but similar structures can also occur from complications of primary and secondary brain tumors, inflammation and autoimmune diseases of the brain, brain trauma, or a manifestation of systemic disease that causes hypertension.
Intra cerebral hematoma is a hematoma caused by bleeding in the cerebral cortex is usually most common in temporal lobe, followed in the frontal, parietal, and sometimes on sereblum.
This bleeding usually comes from the artery, so that very quickly entered into the ventrical and pressing the brain stem as well as others.
Monday, November 15, 2010
Friday, November 12, 2010
PENERIMAAN CPNS 2010 - 2011 KABUPATEN BANJAR NEGARA, BANYUMAS, BATANG, BLORA, BOYOLALI, BREBES, CILACAP, GROBOGAN, JEPARA, KARANGANYAR, KEBUMEN, KENDA
JANGAN LUPA MENULIS DIKOLOM KOMENTAR YA KALO SUDAH AMBIL FILE NYA....MAKASIH.....
KABUPATEN BANJAR NEGARA
BANYUMAS
BATANG
BLORA
BOYOLALI
BREBES
CILACAP
GROBOGAN
JEPARA
KARANGANYAR
KEBUMEN
KENDAL
KLATEN
KUDUS
MAGELANG
PATI
PEKALONGAN
PURWOREJO
SEMARANG
SRAGEN
SUKOHARJO
TEGAL
TEMANGGUNG
WONOGIRI
WONOSOBO
KOTA MAGELANG
KOTA PEKALONGAN
SALATIGA
SURAKARTA / SOLO
KOTA TEGAL
PROVINSI JAWA TENGAH
KABUPATEN BANJAR NEGARA
BANYUMAS
BATANG
BLORA
BOYOLALI
BREBES
CILACAP
GROBOGAN
JEPARA
KARANGANYAR
KEBUMEN
KENDAL
KLATEN
KUDUS
MAGELANG
PATI
PEKALONGAN
PURWOREJO
SEMARANG
SRAGEN
SUKOHARJO
TEGAL
TEMANGGUNG
WONOGIRI
WONOSOBO
KOTA MAGELANG
KOTA PEKALONGAN
SALATIGA
SURAKARTA / SOLO
KOTA TEGAL
PROVINSI JAWA TENGAH
Monday, November 8, 2010
REKRUITMEN PENERIMAAN CPNS 2010-2011 PROVINSI BALI, BANJARMASIN JAWA TENGAH JATENG, KABUPATEN BANGKA
PEMPROV BALI, BANJARMASIN DAN KABUPATEN BANGKA SUDAH MENGELUARKAN PENGUMUMAN PENERIMAAN CPNS 2010 - 2011... SILAHKAN DI PANTAU......
KLIK untuk PROPINSI BALI
KLIK untuk BANJARMASIN
KLIK untuk KABUPATEN BANGKA
KLIK untuk JAWA TENGAH ( JATENG )
KLIK untuk PROPINSI BALI
KLIK untuk BANJARMASIN
KLIK untuk KABUPATEN BANGKA
KLIK untuk JAWA TENGAH ( JATENG )
Thursday, October 28, 2010
INFORMASI PENERIMAAN PEGAWAI CPNS 2010-2011 , CPNSD 2010-2011 , CPNS DEPARTEMEN 2010 - 2011 , CPNS KEMENTERIAN 2010 - 2011 TERLENGKAP DISINI TEMPATNYA
Sunday, October 3, 2010
क्प्न्स 2010
CPNS 2010 DEPARTEMEN KESEHATAN
VISITE >>>>>>>>>>> http://ropeg-depkes.or.id/ <<<<<<<<<<<<<<<<
VISITE >>>>>>>>>>> http://ropeg-depkes.or.id/ <<<<<<<<<<<<<<<<
Friday, June 18, 2010
SECRET Vocal (singing) THE RIGHT
SECRET Vocal (singing) THE RIGHT
to become a singer in need knowledge of basic vocal techniques
. Where the goal to produce the sounds & melodic tones and beautiful, besides knowing the use of our vocal chords do not really broken.
Elements of vocal technique:
1. Posture
2. Respiratory Diaphragm
3. Sound Formation
4. Articulation Pronunciation
5. Resonance
6. Phrasering
7. Vibrato
That need to be noticed in the singing voice for singing that is not the same as a voice in everyday conversations.
Voice for singing requires the management of the high tones of low, rythem a uniform. Therefore there are some things that need to be noticed in singing.
1. Body attitude, standing or sitting can be done in singing. Should not be stiff and tense, his hands there should be no burden and disturb the chest cavity, should be relaxed and free.
2. Breathing is the most important element in singing. Taking the air as much as possible and remove them sparingly and slowly. Chest and abdominal breathing is not good because it is very shallow and may not be durable or quickly exhausted. This is a good respiratory diaphragm used to sing, because it can pull in breathing is deeper and can last longer. The most effective breathing exercise that is with a hissing sound or with a notation. It should be in the know that breathing is difficult in the set and the master when in a state:
• Less Healthy
• anxiety, fear, and sadness
• Lack of concentration due to stage fright
3. Establishment of sound
a. Organ Sound
When the voice in the larynx there is a human voice source.
Beep sound derived from the membrane, there are 2 kinds of noise and ringing. That some kind of fricative sounds eruption of the membrane, frequency fricative is not regular. While the tone of our voice that was singing was loud, since membrane stretched flat and balanced voice to any regular frequency.
Then to get a beautiful voice in singing, ringing sound coming from the membrane should be in though again in a resonant space with a falsetto voice Voice (voice fake).
Falsetto voice should go into resonant cavities of the chest cavity, pharynx cavity, cavity sinuses, oral cavity, the cavity of the head. In this resonant cavities is the sound that comes from the vocal cords in the widening, then in the resonant cavities of this reason, if the voice in vocal techniques to generate sound tones are beautiful.
Sound Processing:
• Shape your mouth with A, I, U, E, O
• Exercise pelemas lips with pi pi pi pi, mo mo mo, mu mu mu
• The position of the tongue - limp on location, not curved, the teeth do not protrude malampaui
4. Articulation (pronunciation)
The words must speak well and clearly. For example ma, pa not be me, moa, pe, POA, etc. A good Speech must use tools that have said we are in the mouth the tongue, teeth, lips and tongue base.
To simplify the utterance of words can be arranged through the oral cavity and tongue and lip position is good.
5. Resonance
Resonance serves to expand and beautify the voice sounded so melodious, loud and charming. Certainly in need of resonance techniques such as set form of the mouth, the position of the lips, tongue position so that a ballot box.
a. A vocal pronunciation
The mouth should be open like a yawning again, somewhat tongue is drawn into the tip of the tongue touching the lower teeth.
b. Pronunciation vocal E
In the open mouth is smaller than the spoken vocals A, then dilated left and right and in the echoes ring.
c. Pronunciation vocal I
Mouth shape is similar to the form of oral vocal pronunciation E. The difference is the upper lip and lower lip is more on the Close and the voiced echoed.
d. O vocal pronunciation
Mouth opened wide and bit his lip in the second round it off and pull the tongue on the inside.
e. U vocal pronunciations
Mouth open in less than vocals A.
Once we do well then the vocals need to practice voicing consonant letters. Consonants are letters that are not sound and can sound when the letters connect with vocals, therefore in exercise voiced consonants accompanied by vocals. Consonants can be classified into several types:
• The letters of the lips (m, b, p)
• The letters teeth (n, t, d)
• The letters hissing (s, c, z)
• The letters at the ceiling (h, g, k)
6. Phrasering
Rules beheading sentences, or sentence music into sections shorter but still has a sense of unity.
Phrasering consists of two types, namely:
• Phrasering sentences
• sentence Phrasering music
7. Vibrato
Wavy voice (live) in singing, not all sentences songs use vibrato, sometimes plain song or sentence reduced. Excessive vibrato can change the tone and vocals, while the vibrations made up like a cold would give the impression
8. Animism
Music is the universal language of the world. From the music and melodies we can animate the song and had to be learned like his verse, dynamics, melodikanya, tempo, character, and tone base. Especially the song's inspiration if we are able to memorize the songs that will be much more perfect.
The music was beautiful and the music is a universal language, through music we can interpret the meaning and purpose of the song. In other words the music is the language of the world.
With vocal coach we can get many benefits:
a. Correcting your voice and speaking
b. Healthty
c. Enrich Your Imagination
d. Self confident
A. Correcting voice and speaking
Many people who sing and speak with one voice so as to produce an unpleasant talk at the hearing. Talk and can not be controlled with a loud and noisy, with a strained sound position, quickly exhausted and tired, my throat felt dry and hoarse and sang one too many, so many tones produce false (false) with sayings that are not clear. High tones that are not reached and low tones that are not appropriate so as to produce the sound and tone that is not melodious, his voice rough, tired and his vocal cords will be hoarse.
If the damage is often done will lead vocal, this is very dangerous, should be quickly cured by the proper vocal exercises.
B. Healthy
By training the vocals we can help our health and to prevent from many diseases:
- Disease vocal cords
- Asthma
- Disease sinusitis
Benefits of vocal training can cure this disease by the resonance pulse in the sinus cavity. Every day he trained so that the sinus cavities clean of lendiran lendiran-it stuck to the cavity.
- Heart disease
- The disease stress
- Diseases mild stroke
- Younger
C. Enrich Your Imagination
Vocals can add to the power train our imagination, we can create songs, menghayal happily, menghayal with sadness, longing and love.
to become a singer in need knowledge of basic vocal techniques
. Where the goal to produce the sounds & melodic tones and beautiful, besides knowing the use of our vocal chords do not really broken.
Elements of vocal technique:
1. Posture
2. Respiratory Diaphragm
3. Sound Formation
4. Articulation Pronunciation
5. Resonance
6. Phrasering
7. Vibrato
That need to be noticed in the singing voice for singing that is not the same as a voice in everyday conversations.
Voice for singing requires the management of the high tones of low, rythem a uniform. Therefore there are some things that need to be noticed in singing.
1. Body attitude, standing or sitting can be done in singing. Should not be stiff and tense, his hands there should be no burden and disturb the chest cavity, should be relaxed and free.
2. Breathing is the most important element in singing. Taking the air as much as possible and remove them sparingly and slowly. Chest and abdominal breathing is not good because it is very shallow and may not be durable or quickly exhausted. This is a good respiratory diaphragm used to sing, because it can pull in breathing is deeper and can last longer. The most effective breathing exercise that is with a hissing sound or with a notation. It should be in the know that breathing is difficult in the set and the master when in a state:
• Less Healthy
• anxiety, fear, and sadness
• Lack of concentration due to stage fright
3. Establishment of sound
a. Organ Sound
When the voice in the larynx there is a human voice source.
Beep sound derived from the membrane, there are 2 kinds of noise and ringing. That some kind of fricative sounds eruption of the membrane, frequency fricative is not regular. While the tone of our voice that was singing was loud, since membrane stretched flat and balanced voice to any regular frequency.
Then to get a beautiful voice in singing, ringing sound coming from the membrane should be in though again in a resonant space with a falsetto voice Voice (voice fake).
Falsetto voice should go into resonant cavities of the chest cavity, pharynx cavity, cavity sinuses, oral cavity, the cavity of the head. In this resonant cavities is the sound that comes from the vocal cords in the widening, then in the resonant cavities of this reason, if the voice in vocal techniques to generate sound tones are beautiful.
Sound Processing:
• Shape your mouth with A, I, U, E, O
• Exercise pelemas lips with pi pi pi pi, mo mo mo, mu mu mu
• The position of the tongue - limp on location, not curved, the teeth do not protrude malampaui
4. Articulation (pronunciation)
The words must speak well and clearly. For example ma, pa not be me, moa, pe, POA, etc. A good Speech must use tools that have said we are in the mouth the tongue, teeth, lips and tongue base.
To simplify the utterance of words can be arranged through the oral cavity and tongue and lip position is good.
5. Resonance
Resonance serves to expand and beautify the voice sounded so melodious, loud and charming. Certainly in need of resonance techniques such as set form of the mouth, the position of the lips, tongue position so that a ballot box.
a. A vocal pronunciation
The mouth should be open like a yawning again, somewhat tongue is drawn into the tip of the tongue touching the lower teeth.
b. Pronunciation vocal E
In the open mouth is smaller than the spoken vocals A, then dilated left and right and in the echoes ring.
c. Pronunciation vocal I
Mouth shape is similar to the form of oral vocal pronunciation E. The difference is the upper lip and lower lip is more on the Close and the voiced echoed.
d. O vocal pronunciation
Mouth opened wide and bit his lip in the second round it off and pull the tongue on the inside.
e. U vocal pronunciations
Mouth open in less than vocals A.
Once we do well then the vocals need to practice voicing consonant letters. Consonants are letters that are not sound and can sound when the letters connect with vocals, therefore in exercise voiced consonants accompanied by vocals. Consonants can be classified into several types:
• The letters of the lips (m, b, p)
• The letters teeth (n, t, d)
• The letters hissing (s, c, z)
• The letters at the ceiling (h, g, k)
6. Phrasering
Rules beheading sentences, or sentence music into sections shorter but still has a sense of unity.
Phrasering consists of two types, namely:
• Phrasering sentences
• sentence Phrasering music
7. Vibrato
Wavy voice (live) in singing, not all sentences songs use vibrato, sometimes plain song or sentence reduced. Excessive vibrato can change the tone and vocals, while the vibrations made up like a cold would give the impression
8. Animism
Music is the universal language of the world. From the music and melodies we can animate the song and had to be learned like his verse, dynamics, melodikanya, tempo, character, and tone base. Especially the song's inspiration if we are able to memorize the songs that will be much more perfect.
The music was beautiful and the music is a universal language, through music we can interpret the meaning and purpose of the song. In other words the music is the language of the world.
With vocal coach we can get many benefits:
a. Correcting your voice and speaking
b. Healthty
c. Enrich Your Imagination
d. Self confident
A. Correcting voice and speaking
Many people who sing and speak with one voice so as to produce an unpleasant talk at the hearing. Talk and can not be controlled with a loud and noisy, with a strained sound position, quickly exhausted and tired, my throat felt dry and hoarse and sang one too many, so many tones produce false (false) with sayings that are not clear. High tones that are not reached and low tones that are not appropriate so as to produce the sound and tone that is not melodious, his voice rough, tired and his vocal cords will be hoarse.
If the damage is often done will lead vocal, this is very dangerous, should be quickly cured by the proper vocal exercises.
B. Healthy
By training the vocals we can help our health and to prevent from many diseases:
- Disease vocal cords
- Asthma
- Disease sinusitis
Benefits of vocal training can cure this disease by the resonance pulse in the sinus cavity. Every day he trained so that the sinus cavities clean of lendiran lendiran-it stuck to the cavity.
- Heart disease
- The disease stress
- Diseases mild stroke
- Younger
C. Enrich Your Imagination
Vocals can add to the power train our imagination, we can create songs, menghayal happily, menghayal with sadness, longing and love.
FUNCTIONS AND BENEFITS OF CYCLING
Functions and Benefits of Cycling
Who do you think cycling is a hobby, a sport which is also effective enough to burn calories the body. When you're cycling, the muscles of the foot pedal bicycles will be withdrawn, the body was followed to maintain a balance so that bicycles can still stand up with a balanced and sliding forward. Meanwhile, your hand will control its navigation. Do not believe everything your body does not move, you are sitting on a bike going through exercises that burn calories.
Nowadays, many office workers, both in America, or Indonesia and other countries mengampanyekan programs 'bike to work'. In addition to environmentally friendly, the program also provides various other benefits, including:
1. Body burns calories!
Had already been discussed above, that the bike will help the body burn calories. Approximately how many calories burned? For example, a woman with a body weight of 50.39 biking as far as 19-22 kilometers in one hour. In one hour she had burned 488 calories her body. Indeed not everyone is experiencing the same burning calories, it all depends on body weight and excess fat that is owned. However, the average cycling for 60 minutes every day will help you burn approximately 300-500 calories the body.
2. Exercising all the muscles of the body!
Not only the muscles of the legs, arms and abdomen, but the entire upper body muscles were also trained. Even by Erik Moen, a physical therapist who frequently handle all athletes, says that the heart also follow this practice with cycling. When racing on the bike, heart rate according to age and race participate strokes, as reported by Womenshealth.
However it should be observed, for you who have asthma or heart disease, always consult your physician before racing on the bicycle. Each body has different abilities according to his condition.
3. As a relaxation of the body
Many who think with practice and exercise the body will be weak and helpless. This assumption is not entirely true, because with regular exercise, even the body will be more fresh and fit. Moreover, blood circulation would be far more smoothly, so that oxygen can be channeled to all parts of the body effectively.
Pain experienced weakness appears only on the first few days only, but if you are already routinely do so, then the muscles will be stronger, and fitter body.
HEALTH TIPS:
* Too much fun cycling, most people will not forget that cycling is a sport that will drive almost all the muscles of the body. Therefore, heating is often considered trivial and forgotten. Careful, heating is very important to do before doing an activity. Therefore make sure you are properly warmed up before the start of cycling.
* Consumption of mineral water is sufficient so that the body did not lose body ions. Or consumption of fruit juice that is rich in vitamins and other nutrients.
Cycling in the morning or go to work, you are free to choose his time. Happy bike to work!
Who do you think cycling is a hobby, a sport which is also effective enough to burn calories the body. When you're cycling, the muscles of the foot pedal bicycles will be withdrawn, the body was followed to maintain a balance so that bicycles can still stand up with a balanced and sliding forward. Meanwhile, your hand will control its navigation. Do not believe everything your body does not move, you are sitting on a bike going through exercises that burn calories.
Nowadays, many office workers, both in America, or Indonesia and other countries mengampanyekan programs 'bike to work'. In addition to environmentally friendly, the program also provides various other benefits, including:
1. Body burns calories!
Had already been discussed above, that the bike will help the body burn calories. Approximately how many calories burned? For example, a woman with a body weight of 50.39 biking as far as 19-22 kilometers in one hour. In one hour she had burned 488 calories her body. Indeed not everyone is experiencing the same burning calories, it all depends on body weight and excess fat that is owned. However, the average cycling for 60 minutes every day will help you burn approximately 300-500 calories the body.
2. Exercising all the muscles of the body!
Not only the muscles of the legs, arms and abdomen, but the entire upper body muscles were also trained. Even by Erik Moen, a physical therapist who frequently handle all athletes, says that the heart also follow this practice with cycling. When racing on the bike, heart rate according to age and race participate strokes, as reported by Womenshealth.
However it should be observed, for you who have asthma or heart disease, always consult your physician before racing on the bicycle. Each body has different abilities according to his condition.
3. As a relaxation of the body
Many who think with practice and exercise the body will be weak and helpless. This assumption is not entirely true, because with regular exercise, even the body will be more fresh and fit. Moreover, blood circulation would be far more smoothly, so that oxygen can be channeled to all parts of the body effectively.
Pain experienced weakness appears only on the first few days only, but if you are already routinely do so, then the muscles will be stronger, and fitter body.
HEALTH TIPS:
* Too much fun cycling, most people will not forget that cycling is a sport that will drive almost all the muscles of the body. Therefore, heating is often considered trivial and forgotten. Careful, heating is very important to do before doing an activity. Therefore make sure you are properly warmed up before the start of cycling.
* Consumption of mineral water is sufficient so that the body did not lose body ions. Or consumption of fruit juice that is rich in vitamins and other nutrients.
Cycling in the morning or go to work, you are free to choose his time. Happy bike to work!
THE RISK OF WOMB CANCER
There was not one person then that knew the cause that was exact from content cancer. Although, was clear that this illness did not spread. There was not one person then that could "comprehend" cancer from the other person. Women who received this illness were more likely to have certain risk factors than other women. A risk factor was something that could increase the possibility of someone developing the illness. Most women who learned risk factors did not receive content cancer. To the other side, many that received this illness did not have these factors. Rare doctors could explain why a woman received content cancer whereas that was other not.
Studies found risk factors along with: the Age. Content cancer happened most to women were more than 50 years old. Endometrial hyperplasia. The risk of content cancer was higher if a woman had endometrial hyperplasia. This condition and his maintenance was discussed above. Pengganti therapy of the Hormone, Hormone replacement therapy (HRT). HRT was used controlled signs of menopause, prevented osteoporosis (penipisan bones), and reduced the risk of the heart disease or stroke. Women who used oestrogen without progesterone had an increase in the risk of content cancer. The long-term use and doses that were big from oestrogen apparently increased this risk. Women who used a combination of oestrogen and progesterone had a risk of content cancer that was lower than women who only used oestrogen then. Progesterone protected the content (the uterus).
Women must discuss benefits and risks from HRT with their doctors. Also, had inspections (checkups) in an orderly fashion when taking HRT could improve the possibility of the doctor of finding content cancer in the beginning stage, if he developed. Obesity and conditions that were connected dengany him. The body made some of his oestrogen in adipose tissue. So why fat women be more likely to than thin women had level-tinkat oestrogen that was higher in his bodies. Levels of high oestrogen possibly were his cause that fat women had an increase in the risk of developing content cancer. The risk of this illness was also higher to women with diabetes or hypertension (conditions that happened to many fat women).
Tamoxifen. Women who drank medicine tamoxifen to prevent or treat breasts cancer had an increase in the risk of content cancer. This risk apparently was connected with the effect that resembled oestrogen from this medicine in the content. Doctors supervised women that drank tamoxifen for the possibility of signs or signs from cancer kandunganb. Benefits from tamoxifen to treat breasts cancer more than the risk of the development of other cancers. Permanently, each woman was different. Any woman that considered to drink tamoxifen must discuss with his doctor about the medical history personal and his family and kekhwatiran-kekhwatiran him. The race. White people's women be more likely to than American women the African descendants got content cancer. Kolorektal cancer (Colorectal cancer). Women who received a form that was bequeathed from cancer kolorektal (colorectal cancer) had a higher risk of developing content cancer than other women. Other risk factors were connected with how long the body of a flattest woman to oestrogen. Women who did not have children, from menstruation in a very young age, or entered menopause late in flattest his life to oestrogen were longer and had a higher risk. Women with risk factors that were known and they that khwatir about content cancer must ask their doctors about signs that must be supervised and how many often did checkups.
Studies found risk factors along with: the Age. Content cancer happened most to women were more than 50 years old. Endometrial hyperplasia. The risk of content cancer was higher if a woman had endometrial hyperplasia. This condition and his maintenance was discussed above. Pengganti therapy of the Hormone, Hormone replacement therapy (HRT). HRT was used controlled signs of menopause, prevented osteoporosis (penipisan bones), and reduced the risk of the heart disease or stroke. Women who used oestrogen without progesterone had an increase in the risk of content cancer. The long-term use and doses that were big from oestrogen apparently increased this risk. Women who used a combination of oestrogen and progesterone had a risk of content cancer that was lower than women who only used oestrogen then. Progesterone protected the content (the uterus).
Women must discuss benefits and risks from HRT with their doctors. Also, had inspections (checkups) in an orderly fashion when taking HRT could improve the possibility of the doctor of finding content cancer in the beginning stage, if he developed. Obesity and conditions that were connected dengany him. The body made some of his oestrogen in adipose tissue. So why fat women be more likely to than thin women had level-tinkat oestrogen that was higher in his bodies. Levels of high oestrogen possibly were his cause that fat women had an increase in the risk of developing content cancer. The risk of this illness was also higher to women with diabetes or hypertension (conditions that happened to many fat women).
Tamoxifen. Women who drank medicine tamoxifen to prevent or treat breasts cancer had an increase in the risk of content cancer. This risk apparently was connected with the effect that resembled oestrogen from this medicine in the content. Doctors supervised women that drank tamoxifen for the possibility of signs or signs from cancer kandunganb. Benefits from tamoxifen to treat breasts cancer more than the risk of the development of other cancers. Permanently, each woman was different. Any woman that considered to drink tamoxifen must discuss with his doctor about the medical history personal and his family and kekhwatiran-kekhwatiran him. The race. White people's women be more likely to than American women the African descendants got content cancer. Kolorektal cancer (Colorectal cancer). Women who received a form that was bequeathed from cancer kolorektal (colorectal cancer) had a higher risk of developing content cancer than other women. Other risk factors were connected with how long the body of a flattest woman to oestrogen. Women who did not have children, from menstruation in a very young age, or entered menopause late in flattest his life to oestrogen were longer and had a higher risk. Women with risk factors that were known and they that khwatir about content cancer must ask their doctors about signs that must be supervised and how many often did checkups.
THE RISK OF WOMB CANCER
There was not one person then that knew the cause that was exact from content cancer. Although, was clear that this illness did not spread. There was not one person then that could "comprehend" cancer from the other person. Women who received this illness were more likely to have certain risk factors than other women. A risk factor was something that could increase the possibility of someone developing the illness. Most women who learned risk factors did not receive content cancer. To the other side, many that received this illness did not have these factors. Rare doctors could explain why a woman received content cancer whereas that was other not.
Studies found risk factors along with: the Age. Content cancer happened most to women were more than 50 years old. Endometrial hyperplasia. The risk of content cancer was higher if a woman had endometrial hyperplasia. This condition and his maintenance was discussed above. Pengganti therapy of the Hormone, Hormone replacement therapy (HRT). HRT was used controlled signs of menopause, prevented osteoporosis (penipisan bones), and reduced the risk of the heart disease or stroke. Women who used oestrogen without progesterone had an increase in the risk of content cancer. The long-term use and doses that were big from oestrogen apparently increased this risk. Women who used a combination of oestrogen and progesterone had a risk of content cancer that was lower than women who only used oestrogen then. Progesterone protected the content (the uterus).
Women must discuss benefits and risks from HRT with their doctors. Also, had inspections (checkups) in an orderly fashion when taking HRT could improve the possibility of the doctor of finding content cancer in the beginning stage, if he developed. Obesity and conditions that were connected dengany him. The body made some of his oestrogen in adipose tissue. So why fat women be more likely to than thin women had level-tinkat oestrogen that was higher in his bodies. Levels of high oestrogen possibly were his cause that fat women had an increase in the risk of developing content cancer. The risk of this illness was also higher to women with diabetes or hypertension (conditions that happened to many fat women).
Tamoxifen. Women who drank medicine tamoxifen to prevent or treat breasts cancer had an increase in the risk of content cancer. This risk apparently was connected with the effect that resembled oestrogen from this medicine in the content. Doctors supervised women that drank tamoxifen for the possibility of signs or signs from cancer kandunganb. Benefits from tamoxifen to treat breasts cancer more than the risk of the development of other cancers. Permanently, each woman was different. Any woman that considered to drink tamoxifen must discuss with his doctor about the medical history personal and his family and kekhwatiran-kekhwatiran him. The race. White people's women be more likely to than American women the African descendants got content cancer. Kolorektal cancer (Colorectal cancer). Women who received a form that was bequeathed from cancer kolorektal (colorectal cancer) had a higher risk of developing content cancer than other women. Other risk factors were connected with how long the body of a flattest woman to oestrogen. Women who did not have children, from menstruation in a very young age, or entered menopause late in flattest his life to oestrogen were longer and had a higher risk. Women with risk factors that were known and they that khwatir about content cancer must ask their doctors about signs that must be supervised and how many often did checkups.
Studies found risk factors along with: the Age. Content cancer happened most to women were more than 50 years old. Endometrial hyperplasia. The risk of content cancer was higher if a woman had endometrial hyperplasia. This condition and his maintenance was discussed above. Pengganti therapy of the Hormone, Hormone replacement therapy (HRT). HRT was used controlled signs of menopause, prevented osteoporosis (penipisan bones), and reduced the risk of the heart disease or stroke. Women who used oestrogen without progesterone had an increase in the risk of content cancer. The long-term use and doses that were big from oestrogen apparently increased this risk. Women who used a combination of oestrogen and progesterone had a risk of content cancer that was lower than women who only used oestrogen then. Progesterone protected the content (the uterus).
Women must discuss benefits and risks from HRT with their doctors. Also, had inspections (checkups) in an orderly fashion when taking HRT could improve the possibility of the doctor of finding content cancer in the beginning stage, if he developed. Obesity and conditions that were connected dengany him. The body made some of his oestrogen in adipose tissue. So why fat women be more likely to than thin women had level-tinkat oestrogen that was higher in his bodies. Levels of high oestrogen possibly were his cause that fat women had an increase in the risk of developing content cancer. The risk of this illness was also higher to women with diabetes or hypertension (conditions that happened to many fat women).
Tamoxifen. Women who drank medicine tamoxifen to prevent or treat breasts cancer had an increase in the risk of content cancer. This risk apparently was connected with the effect that resembled oestrogen from this medicine in the content. Doctors supervised women that drank tamoxifen for the possibility of signs or signs from cancer kandunganb. Benefits from tamoxifen to treat breasts cancer more than the risk of the development of other cancers. Permanently, each woman was different. Any woman that considered to drink tamoxifen must discuss with his doctor about the medical history personal and his family and kekhwatiran-kekhwatiran him. The race. White people's women be more likely to than American women the African descendants got content cancer. Kolorektal cancer (Colorectal cancer). Women who received a form that was bequeathed from cancer kolorektal (colorectal cancer) had a higher risk of developing content cancer than other women. Other risk factors were connected with how long the body of a flattest woman to oestrogen. Women who did not have children, from menstruation in a very young age, or entered menopause late in flattest his life to oestrogen were longer and had a higher risk. Women with risk factors that were known and they that khwatir about content cancer must ask their doctors about signs that must be supervised and how many often did checkups.
PERIKONDRITIS
PERIKONDRITIS
Apa itu perikondritis?
Perikondritis adalah radang pada tulang rawan daun telinga yang terjadi akibat trauma, pasca operasi telinga serta sebagai komplikasi hematoma daun telinga, otitis eksterna kronik, otitis media kronik dan pseudokita.
Serta bagaimana perjalanan penyakitnya ?
Akibat peradangan, terjadi efusi serum dan pus ke dalam lapisan perikondrium dan tulang rawan dari telinga luar.
Apa tanda dan gejalanya ?
Tampak daun telinga membengkak, merah, panas, dirasakan nyeri, dan nyeri tekan. Pembengkakan ini dapat menjalar ke bagian belakang daun telinga, sehingga sangat menonjol. Terdapat demam, pembesaran kelenjar limfe regional, dan leukositosis. Serum yang terkumpul di lapisan subperikondrial menjadi purulen, sehingga terdapat fluktuasi difus atau terlokalisasi.
Bagaimana penatalaksanaanya?
Pengobatan dengan antibiotic sering gagal karena kuman yang dituju, pseudomonas aeruginosa, sering resisten terhadap sebagian besar antibiotic. Yang paling efektif adalah trobamisin di berikan bersama-sama tikarsilin secara sistemik, selama dua minggu, dengan memantau funsi ginjal. Antibiotic di berikan secara parenteral atau topical. Sebaiknya dilakukan kultur sebelumnya.
Pada daun telinga di berikan kompres panas. Bila terdapat fluktuasi, dilakukan insisi secara steril dan di beri perban tekan selama 48 jam seperti pada hematoma daun telinga.
Apa komplikasi yang bias terjadi ?
Tulang rawan hancur dan menciut serta keriput, disebut telinga lisut ( cauliflower ), sehingga perlu dilakukan rekonstruksi.
Apa itu perikondritis?
Perikondritis adalah radang pada tulang rawan daun telinga yang terjadi akibat trauma, pasca operasi telinga serta sebagai komplikasi hematoma daun telinga, otitis eksterna kronik, otitis media kronik dan pseudokita.
Serta bagaimana perjalanan penyakitnya ?
Akibat peradangan, terjadi efusi serum dan pus ke dalam lapisan perikondrium dan tulang rawan dari telinga luar.
Apa tanda dan gejalanya ?
Tampak daun telinga membengkak, merah, panas, dirasakan nyeri, dan nyeri tekan. Pembengkakan ini dapat menjalar ke bagian belakang daun telinga, sehingga sangat menonjol. Terdapat demam, pembesaran kelenjar limfe regional, dan leukositosis. Serum yang terkumpul di lapisan subperikondrial menjadi purulen, sehingga terdapat fluktuasi difus atau terlokalisasi.
Bagaimana penatalaksanaanya?
Pengobatan dengan antibiotic sering gagal karena kuman yang dituju, pseudomonas aeruginosa, sering resisten terhadap sebagian besar antibiotic. Yang paling efektif adalah trobamisin di berikan bersama-sama tikarsilin secara sistemik, selama dua minggu, dengan memantau funsi ginjal. Antibiotic di berikan secara parenteral atau topical. Sebaiknya dilakukan kultur sebelumnya.
Pada daun telinga di berikan kompres panas. Bila terdapat fluktuasi, dilakukan insisi secara steril dan di beri perban tekan selama 48 jam seperti pada hematoma daun telinga.
Apa komplikasi yang bias terjadi ?
Tulang rawan hancur dan menciut serta keriput, disebut telinga lisut ( cauliflower ), sehingga perlu dilakukan rekonstruksi.
HOW TO PRESERVE THE HEALTH EYE
HOW TO PRESERVE THE HEALTH EYE
Tired Eyes
Use avocado to cool and refresh tired eyes or swollen. Avocado useful because many contain vitamins A, C, E, iron, potassium, niacin, pantatenik acid, and protein.
How: Peel an avocado and cut into thin slabs resemble. Stick it on tired eyes or swollen, then let stand for 20 minutes. Clean the remaining avocado with cold water.
Tired eyes can also be overcome by rubbing ice cubes around the eyes for several minutes. This will restore the smooth circulation of blood and refresh the eyes.
Black Circle
Problems that often appear dark circles under the eyes, can be treated with cucumber cheap and easily available. In this vegetable contains lots of minerals and water.
How: Take the cucumber and slice thinly. Use slices of cucumber to compress the eye for 15 minutes.
Red Eye
Reddened eyes and fatigue can be overcome with the cooking water merambang with betel leaf.
How: A handful of betel leaves and young stems and leaf stalks boiled in 3 cups water to boil. Once cool, use the decoction water to merambang eyeball. That sounds good in a way that water dripping on the eye.
To overcome the red eyes from lack of sleep, do compress the eye with water that has been deposited black tea one night.
Make Eye Ball Bening
1 tablespoon brewed tea with a glass of water. Leave overnight and tomorrow morning the new strained. Use this water to wash the eyes with merambang eyes for 3-5 minutes. Stung initially, but slowly going cold and the eye feels uncomfortable.
Tired Eyes
Use avocado to cool and refresh tired eyes or swollen. Avocado useful because many contain vitamins A, C, E, iron, potassium, niacin, pantatenik acid, and protein.
How: Peel an avocado and cut into thin slabs resemble. Stick it on tired eyes or swollen, then let stand for 20 minutes. Clean the remaining avocado with cold water.
Tired eyes can also be overcome by rubbing ice cubes around the eyes for several minutes. This will restore the smooth circulation of blood and refresh the eyes.
Black Circle
Problems that often appear dark circles under the eyes, can be treated with cucumber cheap and easily available. In this vegetable contains lots of minerals and water.
How: Take the cucumber and slice thinly. Use slices of cucumber to compress the eye for 15 minutes.
Red Eye
Reddened eyes and fatigue can be overcome with the cooking water merambang with betel leaf.
How: A handful of betel leaves and young stems and leaf stalks boiled in 3 cups water to boil. Once cool, use the decoction water to merambang eyeball. That sounds good in a way that water dripping on the eye.
To overcome the red eyes from lack of sleep, do compress the eye with water that has been deposited black tea one night.
Make Eye Ball Bening
1 tablespoon brewed tea with a glass of water. Leave overnight and tomorrow morning the new strained. Use this water to wash the eyes with merambang eyes for 3-5 minutes. Stung initially, but slowly going cold and the eye feels uncomfortable.
TEST FOR NURSING MOTHERS
Tests for Nursing Mothers
Are you a mother who is breastfeeding? High-Desert have some questions for you.
Does your baby's weight increases?
Added a constant weight was a sign that the baby getting enough food intake. Weight is lost when the new born will usually grow back again and within ten days to two weeks. Although every baby examination must involve the process of body weight, you can add a schedule of weighing if you are worried or concerned about your baby's weight.
How often do you breastfeed your baby?
Newborn babies are usually fed as many as eight to twelve times a day or once every two to three hours. During development, your baby will be requested to breastfeed longer. Trust your body the ability to fulfill the request.
Can you hear your baby swallowing?
If you look carefully, you will hear the sound when your baby swallowing. Also note the rhythmic movement, constant, and stronger in the lower jaw to your baby. Even a drop of water may drip milk from your baby's mouth.
How do you feel in your breasts while breastfeeding?
When the proper position of your baby's mouth, you will feel the gentle sensation in the breast, not like being bitten or pinched. In addition, your breasts will feel hard or full before feeding and then becomes more gentle and empty afterward. If breastfeeding is painful for you, consult with your doctor.
Is your baby getting enough milk?
This can be identified from several things, among them seem satisfied after feeding, good reflexes, and active. Notice also the color of your baby's skin.
Do you already provide good nutrition for your baby?
ASI is a food source that has the most complete nutrition. But the quality of breast milk depends on the quality of food and beverages consumed by the mother is breastfeeding. That's why you can now find many brands of milk specifically for nursing mothers.
How do I complete nutritional feeding mother so the mother can provide good quality milk?
Are you a mother who is breastfeeding? High-Desert have some questions for you.
Does your baby's weight increases?
Added a constant weight was a sign that the baby getting enough food intake. Weight is lost when the new born will usually grow back again and within ten days to two weeks. Although every baby examination must involve the process of body weight, you can add a schedule of weighing if you are worried or concerned about your baby's weight.
How often do you breastfeed your baby?
Newborn babies are usually fed as many as eight to twelve times a day or once every two to three hours. During development, your baby will be requested to breastfeed longer. Trust your body the ability to fulfill the request.
Can you hear your baby swallowing?
If you look carefully, you will hear the sound when your baby swallowing. Also note the rhythmic movement, constant, and stronger in the lower jaw to your baby. Even a drop of water may drip milk from your baby's mouth.
How do you feel in your breasts while breastfeeding?
When the proper position of your baby's mouth, you will feel the gentle sensation in the breast, not like being bitten or pinched. In addition, your breasts will feel hard or full before feeding and then becomes more gentle and empty afterward. If breastfeeding is painful for you, consult with your doctor.
Is your baby getting enough milk?
This can be identified from several things, among them seem satisfied after feeding, good reflexes, and active. Notice also the color of your baby's skin.
Do you already provide good nutrition for your baby?
ASI is a food source that has the most complete nutrition. But the quality of breast milk depends on the quality of food and beverages consumed by the mother is breastfeeding. That's why you can now find many brands of milk specifically for nursing mothers.
How do I complete nutritional feeding mother so the mother can provide good quality milk?
QUICK TIPS FOR PREGNANT
Quick Tips For Pregnant
Pregnancy and get descent is a great hope as a partner suamiisteri, especially for those who just got married. The presence of fruit in the hearts of family life add to the atmosphere complete. The moment when the pregnancy test showed positive results, is a highly awaited moment by the couple for those who crave the presence of family generations.
But sometimes, hope will get a pregnancy and the offspring started to disappear when the pregnancy was the long-awaited yet to come as well. Stress and hopelessness upon many couples who have long waited for. Sometimes these conditions create a lot of families became strained and eventually divorce because of this case. Actually, many cases which cause difficulties of a husband and wife to have a child, at the onset of the disease, hormonal disorders, disorders of the reproductive system and various other things of course this should be done further investigation and treatment to overcome it. But sometimes also a husband and wife is difficult to quickly get pregnant due to lack of basic knowledge about pregnancy, so that in later pregnancies is yet to come as well.
Here are some tips that can be performed for the couple husband and wife in order to quickly get a pregnancy:
Check with your Health Conditions
The first thing to do is to conduct a medical examination that includes your own body's health, on your reproductive system, fertility rates and other matters to a professional. Check with this case both husband and wife. This is of capital importance for the occurrence of pregnancy and to be known by the husband-wife, because if there is constraint on these things, of course, needed further care and treatment and not just tips. If after your condition checked and declared healthy and your spouse, then the next tips might be useful and you can do.
The occurrence of Basic Knowledge Know About Pregnancy
It is also important to know the couples that can be used as an illustration to get pregnant. Knowing how much the number of normal sperm, the condition of the cervix during the fertile time, how long the sperm reaches the egg and so on. Details about the process of pregnancy, can be read through the articles below:
The occurrence of Pregnancy
Applying Pattern Healthy Living
Another thing that is no less important is to adopt a healthy lifestyle. Here's what you should consider:
If by chance you or your husband's a smoker, should stop smoking. drinking habits as well as alkhohol.
drinking alcohol reduces the slightest chance of pregnancy up to 50%
Ensure Your Weight Not Less / No More (ideal) because the weight is less / more than could complicate conception, also becomes a problem when you are pregnant. Whereas for men, lack of weight can reduce sperm formation.
Sports diligent, thus the condition of your body is always fit and in the process of fertilization would be greater there.
Balanced Nutritious Diet in nutrient packed foods needed to obtain a healthy pregnancy later.
Know Your Fertile Period
Fertile period was marked by a significant increase in luteinizing hormone just before ovulation (release of eggs from the ovaries). LH increase will push out the egg from the ovary into the fallopian tubes. In the fallopian tubes can occur fertilization by sperm. This period is called the fertile period, when the egg is there and ready to be fertilized. Ovum in the fallopian tube for about 3-4 days but only until the age of two days of the best to be fertilized, after it was dead.
To know how to calculate your fertile period, please complete our articles:
Calculating the Fertile Period
Learn and Avoid Problems Fertility (Infertility)
Fertility problems caused by disturbance of the reproductive system in women and the decreasing quality and quantity of sperm in men. A study shows that fertility problems occurred in 40% due to the women, 40% due to the male and 30% due to both.
Selengkapanya on this subject:
Article: Causes of fertility problems
Video: Women's fertility problems
Use the Associated Board of The Right Position
Many fertility experts who argue that the position of men over the body when exposed to give the best chance for pregnancy. To be effective, she can prop her hips with a pillow so her cervix could accommodate a lot of sperm. Try after ejaculation occurs between partners, for 10-20 minutes so that women remain in a lying position. Do not move it from the attitude of this lie because the minute this time the liquid cement will melt, and if the woman got up liquid cement will flow back into the vagina and create an acid environment weakened and dead sperm. This is also an order for a woman's fertility can be maintained adequately.
Relax At present atmosphere Connected
This husband and wife and related activities should be done in a relaxed and romantic. When fertile period arrived and planned to have sex, and prepare a reasonable time. If the completed activities of a work, rest beforehand to give the body a refreshing time. Bathing can be a way to make the body become refreshed. Keep your mood and relax, do not be too stressful in sexual relationships, for example, think about whether the "activities" this time will produce a pregnancy.
Vitamin Drink
To quickly get pregnant, the consumption of foods containing vitamins and substances needed for fertility is very important for you and your partner. Vitamin C, one of them, can improve sperm quality. Consume 1000 mg and 10 mcg of vitamin D or vitamin E can increase the fertility of men and women. And women who consume folic acid pregnant have a better chance than those who did not consume them. Folic acid also plays an important role in the formation of the fetal brain tube later.
Pray To The Almighty
Human beings are only able to plan and attempt, while surely God determines everything. Therefore equip your business with a prayer to Him, so blessed with the gift of pregnancy as soon as possible. Prayer is so strong, capable of realizing the impossible becomes possible. So, pray!
Pregnancy and get descent is a great hope as a partner suamiisteri, especially for those who just got married. The presence of fruit in the hearts of family life add to the atmosphere complete. The moment when the pregnancy test showed positive results, is a highly awaited moment by the couple for those who crave the presence of family generations.
But sometimes, hope will get a pregnancy and the offspring started to disappear when the pregnancy was the long-awaited yet to come as well. Stress and hopelessness upon many couples who have long waited for. Sometimes these conditions create a lot of families became strained and eventually divorce because of this case. Actually, many cases which cause difficulties of a husband and wife to have a child, at the onset of the disease, hormonal disorders, disorders of the reproductive system and various other things of course this should be done further investigation and treatment to overcome it. But sometimes also a husband and wife is difficult to quickly get pregnant due to lack of basic knowledge about pregnancy, so that in later pregnancies is yet to come as well.
Here are some tips that can be performed for the couple husband and wife in order to quickly get a pregnancy:
Check with your Health Conditions
The first thing to do is to conduct a medical examination that includes your own body's health, on your reproductive system, fertility rates and other matters to a professional. Check with this case both husband and wife. This is of capital importance for the occurrence of pregnancy and to be known by the husband-wife, because if there is constraint on these things, of course, needed further care and treatment and not just tips. If after your condition checked and declared healthy and your spouse, then the next tips might be useful and you can do.
The occurrence of Basic Knowledge Know About Pregnancy
It is also important to know the couples that can be used as an illustration to get pregnant. Knowing how much the number of normal sperm, the condition of the cervix during the fertile time, how long the sperm reaches the egg and so on. Details about the process of pregnancy, can be read through the articles below:
The occurrence of Pregnancy
Applying Pattern Healthy Living
Another thing that is no less important is to adopt a healthy lifestyle. Here's what you should consider:
If by chance you or your husband's a smoker, should stop smoking. drinking habits as well as alkhohol.
drinking alcohol reduces the slightest chance of pregnancy up to 50%
Ensure Your Weight Not Less / No More (ideal) because the weight is less / more than could complicate conception, also becomes a problem when you are pregnant. Whereas for men, lack of weight can reduce sperm formation.
Sports diligent, thus the condition of your body is always fit and in the process of fertilization would be greater there.
Balanced Nutritious Diet in nutrient packed foods needed to obtain a healthy pregnancy later.
Know Your Fertile Period
Fertile period was marked by a significant increase in luteinizing hormone just before ovulation (release of eggs from the ovaries). LH increase will push out the egg from the ovary into the fallopian tubes. In the fallopian tubes can occur fertilization by sperm. This period is called the fertile period, when the egg is there and ready to be fertilized. Ovum in the fallopian tube for about 3-4 days but only until the age of two days of the best to be fertilized, after it was dead.
To know how to calculate your fertile period, please complete our articles:
Calculating the Fertile Period
Learn and Avoid Problems Fertility (Infertility)
Fertility problems caused by disturbance of the reproductive system in women and the decreasing quality and quantity of sperm in men. A study shows that fertility problems occurred in 40% due to the women, 40% due to the male and 30% due to both.
Selengkapanya on this subject:
Article: Causes of fertility problems
Video: Women's fertility problems
Use the Associated Board of The Right Position
Many fertility experts who argue that the position of men over the body when exposed to give the best chance for pregnancy. To be effective, she can prop her hips with a pillow so her cervix could accommodate a lot of sperm. Try after ejaculation occurs between partners, for 10-20 minutes so that women remain in a lying position. Do not move it from the attitude of this lie because the minute this time the liquid cement will melt, and if the woman got up liquid cement will flow back into the vagina and create an acid environment weakened and dead sperm. This is also an order for a woman's fertility can be maintained adequately.
Relax At present atmosphere Connected
This husband and wife and related activities should be done in a relaxed and romantic. When fertile period arrived and planned to have sex, and prepare a reasonable time. If the completed activities of a work, rest beforehand to give the body a refreshing time. Bathing can be a way to make the body become refreshed. Keep your mood and relax, do not be too stressful in sexual relationships, for example, think about whether the "activities" this time will produce a pregnancy.
Vitamin Drink
To quickly get pregnant, the consumption of foods containing vitamins and substances needed for fertility is very important for you and your partner. Vitamin C, one of them, can improve sperm quality. Consume 1000 mg and 10 mcg of vitamin D or vitamin E can increase the fertility of men and women. And women who consume folic acid pregnant have a better chance than those who did not consume them. Folic acid also plays an important role in the formation of the fetal brain tube later.
Pray To The Almighty
Human beings are only able to plan and attempt, while surely God determines everything. Therefore equip your business with a prayer to Him, so blessed with the gift of pregnancy as soon as possible. Prayer is so strong, capable of realizing the impossible becomes possible. So, pray!
MATERNAL AND FETAL HEALTH
maternal and fetal health
Matters Requiring Attention in Early Pregnancy:
Eat 1-2 dishes more nutritious foods in a day-especially if you're skinny, eat more vegetables and fruit, side dishes - red meat, chicken, eggs, fish, peas and beans every day.
Check regularly to pregnancy midwife or other health care workers.
Drinking from the midwife iron supplements every day to prevent bleeding during childbirth.
Receive an injection of TT 2 times during pregnancy
Using iodized salt in food every day for fetal health.
Keep doing everyday activities and exercise regularly, but take care not too tired.
The things that must be avoided For Fetal Health
Working too hard and not getting enough rest.
Indiscriminate medicine unless a doctor's prescription.
Abdominal massage.
Being around children with measles or German measles.
Smoke
Drinking alcoholic beverages
Working with and inhaling pesticides, herbicides or other chemicals.
Eating too little with monotonous menus, no food should be avoided throughout pregnancy.
First Aid Instructions To overcome the problem Lightweight During Pregnancy
Nausea or vomiting, try eating small portions but regularly although no appetite. If it still continues, the midwife may be able to give medication.
Burned-heat or in the stomach or chest cavity (stomach acid, and breathing difficulty) - Eating foods in small portions until they run out and drink lots air.Bidan might give the drug.
Rest swollen legs with her feet up for a couple of times a day. Eat regularly and less salty foods such as instant noodles tiggi. If the foot is very swollen, followed by swelling of the hands and face, immediately go for treatment.
Back Pain: It could be overcome through sports and the attitude of sitting and standing upright.
Too skinny, pale, and weak: Eat more along with side dishes such as peas, beans, chicken, milk, eggs, red meat, fish and dark green vegetables. Drinking iron capsules daily.
Constipation: Drink plenty of water, approximately 6-8 cups a day. Eat plenty of fruits, vegetables, and sweet. Many sports
Early Pregnancy danger signs
Bleeding: Lie still and call officers kesehatan.Jika bleeding occurred in the late-pregnancy after six months, immediately went to the Hospital
Acute Anemia: Feeling increasingly weak, tired quickly, and looked pale; should ask iron capsules to the health worker. Better to give birth in hospitals because of the high risk of bleeding.
Swollen feet in the last three months of pregnancy with symptoms of swollen hands, face, dizziness prolonged, or pengelihatannya be disturbed; can become serious problems-could be affected by toxemia or poisoning kehamilan.Segera went to health officials. If indeed suffer pregnancy toxemia, it is important to:
complete bed rest
Eat a healthy diet
If there is no change in symptoms, is still experiencing vision problems, swollen face and foaming at the mouth (symptoms of epilepsy), immediately went to the hospital, or they could die.
Matters Requiring Attention in Early Pregnancy:
Eat 1-2 dishes more nutritious foods in a day-especially if you're skinny, eat more vegetables and fruit, side dishes - red meat, chicken, eggs, fish, peas and beans every day.
Check regularly to pregnancy midwife or other health care workers.
Drinking from the midwife iron supplements every day to prevent bleeding during childbirth.
Receive an injection of TT 2 times during pregnancy
Using iodized salt in food every day for fetal health.
Keep doing everyday activities and exercise regularly, but take care not too tired.
The things that must be avoided For Fetal Health
Working too hard and not getting enough rest.
Indiscriminate medicine unless a doctor's prescription.
Abdominal massage.
Being around children with measles or German measles.
Smoke
Drinking alcoholic beverages
Working with and inhaling pesticides, herbicides or other chemicals.
Eating too little with monotonous menus, no food should be avoided throughout pregnancy.
First Aid Instructions To overcome the problem Lightweight During Pregnancy
Nausea or vomiting, try eating small portions but regularly although no appetite. If it still continues, the midwife may be able to give medication.
Burned-heat or in the stomach or chest cavity (stomach acid, and breathing difficulty) - Eating foods in small portions until they run out and drink lots air.Bidan might give the drug.
Rest swollen legs with her feet up for a couple of times a day. Eat regularly and less salty foods such as instant noodles tiggi. If the foot is very swollen, followed by swelling of the hands and face, immediately go for treatment.
Back Pain: It could be overcome through sports and the attitude of sitting and standing upright.
Too skinny, pale, and weak: Eat more along with side dishes such as peas, beans, chicken, milk, eggs, red meat, fish and dark green vegetables. Drinking iron capsules daily.
Constipation: Drink plenty of water, approximately 6-8 cups a day. Eat plenty of fruits, vegetables, and sweet. Many sports
Early Pregnancy danger signs
Bleeding: Lie still and call officers kesehatan.Jika bleeding occurred in the late-pregnancy after six months, immediately went to the Hospital
Acute Anemia: Feeling increasingly weak, tired quickly, and looked pale; should ask iron capsules to the health worker. Better to give birth in hospitals because of the high risk of bleeding.
Swollen feet in the last three months of pregnancy with symptoms of swollen hands, face, dizziness prolonged, or pengelihatannya be disturbed; can become serious problems-could be affected by toxemia or poisoning kehamilan.Segera went to health officials. If indeed suffer pregnancy toxemia, it is important to:
complete bed rest
Eat a healthy diet
If there is no change in symptoms, is still experiencing vision problems, swollen face and foaming at the mouth (symptoms of epilepsy), immediately went to the hospital, or they could die.
HEMODIALISA
HEMODIALISA
Hemodialisa adalah suatu teknologi tinggi sebagai terapi pengganti fungsi ginjal untuk mengeluarkan
sisa-sisa metabolisme atau racun tertentu dari peredaran darah manusia seperti air, natrium, kalium,
hydrogen, urea, kreatinin, asam urat, dan zat-zat lain melalui membran semi permeable sebagai pemisah
darah dan cairan dialisat pada ginjal buatan dimana terjadi proses difusi, osmosis dan ultra filtrasi.
PERAWATAN HEMODIALISA
1.PERAWATAN SEBELUM HEMODIALISIS (PRA HD)
Persiapan mesin
Listrik
Air (sudah melalui pengolahan)
Saluran pembuangan
Dialisat (proportioning sistim, batch sistim)
Persiapan peralatan + obat-obatan
Dialyzer/ Ginjal buatan (GB)
AV Blood line
AV fistula/abocath
Infuse set
Spuit : 50 cc, 5 cc, dll ; insulin
Heparin inj
Xylocain (anestesi local)
NaCl 0,90 %
Kain kasa/ Gaas steril
Duk steril
Sarung tangan steril
Bak kecil steril
Mangkuk kecil steril
Klem
Plester
Desinfektan (alcohol + bethadine)
Gelas ukur (mat kan)
Timbangan BB
Formulir hemodialisis
Sirkulasi darah
Cuci tangan
Letakkan GB pada holder, dengan posisi merah diatas
Hubungkan ujung putih pada ABL dengan GB ujung merah
Hubungkan ujung putih VBL dengan GB ujung biru, ujung biru VBL dihubungkan dengan alat penampung/ mat-kan
Letakkan posisi GB terbalik, yaitu yang tanda merah dibawah, biru diatas
Gantungkan NaCl 0,9 % (2-3 kolf)
Pasang infus set pada kolf NaCl
Hubungkan ujung infus set dengan ujung merah ABL atau tempat khusus
Tutup semua klem yang ada pada slang ABL, VBL, (untuk hubungan tekanan arteri, tekanan vena, pemberian obat-obatan)
Buka klem ujung dari ABL, VBL dan infus set
Jalankan Qb dengan kecepatan kurang lebih 100 ml/m
Udara yang ada dalam GB harus hilang (sampai bebeas udara) dengan cara menekan-nekan VBL
Air trap/Bubble trap diisi 2/3-3/4 bagian
Setiap kolf NaCl sesudah/ hendak mengganti kolf baru Qb dimatikan
Setelah udara dalam GB habis, hubungkan ujung ABL dengan ujung VBL, klem tetap dilepas
Masukkan heparin dalam sirkulasi darah sebanyak 1500-2000 U
Ganti kolf NaCl dengan yang baru yang telah diberi heparin 500 U dan klem infus dibuka
Jalankan sirkulasi darah + soaking (melembabkan GB) selama 10-15 menit sebelu dihubungkan dengan sirkulasi sistemik (pasien)
CATATAN !!!!
PERSIAPAN SIRKULASI
Rinsing/Membilas GB + VBL + ABL
Priming/ mengisi GB + VBL + ABL
Soaking/ melembabkan GB.
Volume priming : darah yang berada dalam sirkulasi (ABL + GB + VBL )
Cara menghitung volume priming :
Σ NaCl yang dipakai membilas dikurangi jumlah NaCl yang ada didalam mat kan (gelas tampung/ ukur)
Contoh :
∑ NaCl yang dipakai membilas : 1000 cc
∑ NaCl yang ada didalam mat kan : 750 cc
Jadi volume priming : 1000 cc – 750 cc = 250 cc
Cara melembabkan (soaking) GB Yaitu dengan menghubungkan GB dengan sirkulasi dialisat
Bila mempergunakan dialyzer reuse / pemakaian GB ulang :
Buang formalin dari kompartemen darah dan kompartemen dialisat
Hubungkan dialyzer dengan selang dialisat Biarkan kurang lebih 15 menit pada posisi rinse
Test formalin dengan tablet clinitest :
Tampung cairan yang keluar dari dialyzer atau drain
Ambil cairan 10 tts (1/2 cc), masukkan ke dalam tabung gelas, masukkan 1 tablet clinitest ke dalam tabung gelas yang sudah berisi cairan
Lihat reaksi :
Warna biru : – / negatif
Warna hijau : + / positif
Warna kuning : + / positif
Warna coklat : +/ positif
Selanjutnya mengisi GB sesuai dengan cara mengisi GB baru
Persiapan pasien
1.Persiapan mental
2.Izin hemodialisis
3.Persiapan fisik :Timbang BB, Posisi, Observasi KU (ukur TTV)
2.PERAWATAN SELAMA HEMODIALISIS (INTRA HD)
Pasien
Sarana hubungan sirkulasi/ akses sirkulasi :
Dengan internal A-V shunt/ fistula cimino
Pasien sebelumnya dianjurkan cuci lengan & tangan
Teknik aseptic + antiseptic : bethadine + alcohol
Anestesi local (lidocain inj, procain inj)
Punksi vena (outlet). Dengan AV fistula no G.14 s/d G.16/ abocath, fiksasi, tutup dengan kasa steril
Berikan bolus heparin inj (dosis awal)
Punksi inlet (fistula), fiksasi, tutup dengan kassa steril
Dengan eksternal A-V shunt (Schibner)
Desinfektan
Klem kanula arteri & vena
Bolus heparin inj (dosis awal)
Tanpa 1 & 2 (femora dll)
Desinfektan
Anestesi local
Punksi outlet/ vena (salah satu vena yang besar, biasanya di lengan).
Bolus heparin inj (dosis awal)
Fiksasi, tutup kassa steril
Punksi inlet (vena/ arteri femoralis)
Raba arteri femoralis
Tekan arteri femoralis
Vena femoralis 0,5 – 1 cm ke arah medial
Anestesi lokal (infiltrasi anetesi)
Vena femoralis dipunksi setelah anestesi lokal 3-5 menit
Fiksasi
Tutup dengan kassa steril
Memulai hemodialisis
1.Ujung ABL line dihubungkan dengan punksi inlet
2.Ujung VBL line dihubungkan dengan punksi outlet
3.Semua klem dibuka, kecuali klem infus set
4.Jalankan pompa darah (blood pump) dengan Qb 100 ml/m, sampai sirkulasi darah terisi darah semua.
5.Pompa darah (blood pump stop, sambungkan ujung dari VBL dengan punksi outlet
6.Fiksasi ABL & VBL (sehingga pasien tidak sulit untuk bergerak)
7.cairan priming diampung di gelas ukur dan jumlahnya dicatat (cairan dikeluarkan sesuai kebutuhan).
8.Jalankan pompa darah dengan Qb = 100 ml/m, setelah 15 menit bisa dinaikkan sampai 300 ml/m (dilihat dari keadaan pasien)
9.Hubungkan selang-selang untuk monitor : venous pressure, arteri pressure, hidupkan air/ blood leak detector
10.Pompa heparin dijalankan (dosis heparin sesuai keperluan). Heparin dilarutkan dengan NaCl
11.Ukur TD, Nadi setiap 1 jam. Bila keadaan pasien tidak baik/ lemah lakukan mengukur TD, N, lebih sering.
12.Isi formulir HD antara lain : Nama, Umur, BB, TD, S, N, P, Tipe GB, Cairan priming yang masuk, makan/minum, keluhan selama HD, masalah selama HD.
CATATAN !!!!
1.Permulaan HD posisi dialyzer terbalik setelah dialyzer bebas udara posisi kembalikan ke posisi sebenarnya.
2.Pada waktu menghubungkan venous line dengan punksi outlet, udara harus diamankan lebih dulu
3.Semua sambungan dikencangkan
4.Tempat-tempat punksi harus harus sering dikontrol, untuk menghindari terjadi perdarahan dari tempat punksi.
Mesin
Memprogram mesin hemodialisis :
1.Qb : 200 – 300 ml/m
2.Qd : 300 – 500 ml/m
3.Temperatur : 36-400C
4.TMP. UFR
5.Heparinisasi
Tekanan (+) /venous pressure
Trans Membran Pressure / TMP Tekanan (-) / dialysate pressure
Tekanan (+) + tekanan (-)
Tekanan / pressure :
Arterial pressure / tekanan arteri : banyaknya darah yang keluar dari tubuh
Venous pressure / tekanan vena : lancar/ tidak darah yang masuk ke dalam.
Heparinisasi
Dosis heparin :
Dosis awal : 25 – 50 U/kg BB
Dosis selanjutnya (maintenance) = 500 – 1000 U/kg BB
Cara memberikan
Kontinus
Intermiten (biasa diberikan tiap 1 jam sampai 1 jam terakhir sebelum HD selesai)
Heparinisasi umum
Kontinus :
Dosis awal : ……. U
Dosis selanjutnya : …… U
Intermitten :
Dosis awal : …… U
Dosis selanjutnya : ……. U
Heparinisasi regional
Dosis awal : …… U
Dosis selanjutnya : ….. U
Protamin : …. U
Heparin : protamin = 100 U : 1 mg
Heparin & protamin dilarutkan dengan NaCl.
Heparin diberikan/ dipasang pada selang sebelum dializer.
Protamin diberikan/ dipasang pada selang sebelum masuk ke tubuh/ VBL.
Heparinisasi minimal
Syarat-syarat :
Dialyzer khusus (kalau ada).
Qb tinggi (250 – 300 ml/m)
Dosis heparin : 500 U (pada sirkulasi darah).
Bilas dengan NaCl setiap : ½ – 1 jam
Banyaknya NaCl yang masuk harus dihitung
Jumlahnya NaCl yang masuk harus dikeluarkan dari tubuh, bisa dimasukkan ke dalam program ultrafiltrasi
CATATAN
Dosis awal : diberikan pada waktu punksi : sirkulasi sistem
Dosis selanjutnya: diberikan dengan sirkulasi (maintenance) ekstra korporeal.
PENGAMATAN OBSERVASI, MONITOR SELAMA HEMODIALISA
1.PASIEN
KU pasien
TTV
Perdarahan
Tempat punksi inlet, outlet
Keluhan/ komplikasi hemodialisis
2.MESIN & PERALATAN
Qb
Qd
Temperature
Koduktiviti
Pressure/ tekanan : arterial, venous, dialysate, UFR
Air leak & Blood leak
Heparinisasi
Sirkulasi ekstra corporeal
Sambungan-sambungan
CATATAN :
Obat menaikkan TD ( tu. pend hipotensi berat) : Efedrin 1 ampul + 10 cc aquadest kmd disuntik 2 ml/IV
3.PERAWATAN SESUDAH HEMODIALISIS (POST HD)
Mengakhiri HD
-Persiapan alat :
-Kain kasa/ gaas steril
-Plester
-Verband gulung
-Alkohol/ bethadine
-Antibiotik powder (nebacetin/ cicatrin)
-Bantal pasir (1-1/2 keram) : pada punksi femoral
Cara bekerja
1.5 menit sebelum hemodialisis berakhir Qb diturunkan sekitar 100cc/m UFR = 0
2.Ukur TD, nadi
3.Blood pump stop
4.Ujung ABL diklem, jarum inlet dicabut , bekas punksi inlet ditekan dengan kassa steril yang diberi betadine.
5.Hubungkan ujung abl dengan infus set
6.Darah dimasukkan ke dalam tubuh dengan do dorong dengan nacl sambil qb dijalankan 100 ml/m (NaCl masuk : 50 – 100 cc)
7.Setelah darah masuk ke tubuh Blood pump stop, ujun VBL diklem.
8.Jarum outlet dicabut, bekas punksi inlet & outlet ditekan dengan kassa steril yang diberi bethadine
9.Bila perdarahan pada punksi sudah berhenti, bubuhi bekas punksi inlet & outlet dengan antibiotik powder, lalu tutup dengan kain kassa/band aid lalu pasang verband.
10.Ukur TTV : TD. N, S, P
11.Timbang BB (kalau memungkinkan)
12.Isi formulir hemodialisis
CATATAN :
1.Cairan pendorong/ pembilas (NaCl) sesuai dengan kebutuhan , kalau perlu di dorong dengan udara ( harus hati-hati)
2.Penekanan bekas punksi dengan 3 jari sekitar 10 menit
3.Bekas punksi femoral lebih lama, setelah perdarahan berhenti, ditekan kembali dengan bantal pasir
4.Bekas punksi arteri penekanan harus tepat, lebih lama
5.Memakai teknik aseptik dan antiseptik
SCRIBNER
1.Pakai sarung tangan
2.Sebelum ABL & VBL dilepas dari kanula maka kanula arteri & kanula vena harus diklem lebih dulu
3.kanula arteri & vena dibilas dengan NaCl yang diberi 2500 U – 300 U heparin inj
4.Kedua sisi kanula dihubungkan kembali dengan konektor
5.Lepas klem pada kedua kanula
6.Fiksasi
7.Pasang balutan dengan sedikit kanula bisa dilihat dari luar, untuk mengetahui ada bekuan atau tidak.
ASUHAN KEPERAWATAN PASIEN HEMODIALISIS
Pada pasien yang baru pertama kali hemodialisis, jika kondisi pasien memungkinkan, pasien diorientasikan pada ruangan paviliun II dan alat-alat yang ada. Selain itu pasien diberikan penjelasan ringkas tentang prosedur yang akan dijalankan, prinsip hemodialisis, diet, pembatasan cairan, perawatan cimino, hal-hal yang boleh dan tidak boleh dilakukan selama hemodialisis dan efek dari hemodialisis.
Pada pre hemodialisis, kegiatan perawatan meliputi : menghidupkan mesin, meyediakan alat-alat, memasang alat pada mesin, sirkulasi cairan NaCl pada mesin, mengawasi penimbangan berat badan pasien, mengukur suhu badan, mengukur tekanan darah dan menghitung denyut nadi.
Pada tahap pemasangan alat dan selama pemasangan, kegiatannya meliputi : desinfeksi daerah penusukan, pemberian anestesi lokal (kalau perlu), penusukan jarum, pemasukan heparin (bolus), selanjutnya menyambung jarum pada arteri blood line. Lalu menekan tombol BFR, membuka klem venous dan arteri blood line, memprogram penurunan berat badan, waktu pelaksanaan, venous pressure, kecepatan aliran heparin dan UFR. Kemudian menghubungkan heparin contnous ke sirkulasi, monitoring pernafasan, makan dan minum, pengaturan posisi tubuh, monitoring alat-alat dan kelancaran sirkulasi darah, mengukur tekanan darah dan menciptakan suasana ruangan untuk mengisi kegiatan pasien selama hemodialisis berlangsung.
Pada tahap penghentian hemodialisis meliputi : penghentian aliran darah, mencabut jarum inlet dan menekan bekas tusukan sambil menunggu sampai aliran darah pada venous blood line habis. Langkah selanjutnya adalah mencabut jarum out line dan menekan bekas tusukan, mengganti gaas bethadine dan fiksasi dengan plester. Setelah penghentian hemodialisis, dilakukan pengukuran tekanan darah, mengukur suhu, mengawasi penimbangan berat badan, membereskan alat-alat dan dilanjutkan dengan desinfeksi alat.
Semua kegiatan baik pada tahap pre hemodialisis selama pemasangan dan penghentian hemodialisis dilakukan oleh perawat kecuali penimbangan berat badan dan minum yang pada beberapa pasien dilakukan sendiri. Disamping itu beberapa pasien telah dapat melaporkan pada perawat apabila ada ketidakberesan pada mesin atau akses vaskular, setelah mencoba mengatasi sendiri.
Sistem pencatatan dan pelaporan yang dijalankan dalam bentuk lembaran observasi pasien yang berisi tentang : TTV sebelum atau selama dan sesudah HD, BB sebelum dan sesudah HD, dosis heparin, program penurunan BB , priming dan keluhan pasien setelah HD.
Pembuatan rencana perawatan pasien sudah berjalan dimana dalam pengkajian meliputi data fisik dan psikososial. Data psikososial yang dikaji sebatas pada adanya rasa cemas dan bosan. Intervensi keperawatan yang dilakukan mengarah kepada pemberian bantuan sepenuhnya. Hal ini dapat terlihat dari kegiatan :
a.Pada tahap persiapan
b.Pada tahap pelaksanaan
c.Pada tahap penghentian
disadur dari :
http://argakyo.blogspot.com
Hemodialisa adalah suatu teknologi tinggi sebagai terapi pengganti fungsi ginjal untuk mengeluarkan
sisa-sisa metabolisme atau racun tertentu dari peredaran darah manusia seperti air, natrium, kalium,
hydrogen, urea, kreatinin, asam urat, dan zat-zat lain melalui membran semi permeable sebagai pemisah
darah dan cairan dialisat pada ginjal buatan dimana terjadi proses difusi, osmosis dan ultra filtrasi.
PERAWATAN HEMODIALISA
1.PERAWATAN SEBELUM HEMODIALISIS (PRA HD)
Persiapan mesin
Listrik
Air (sudah melalui pengolahan)
Saluran pembuangan
Dialisat (proportioning sistim, batch sistim)
Persiapan peralatan + obat-obatan
Dialyzer/ Ginjal buatan (GB)
AV Blood line
AV fistula/abocath
Infuse set
Spuit : 50 cc, 5 cc, dll ; insulin
Heparin inj
Xylocain (anestesi local)
NaCl 0,90 %
Kain kasa/ Gaas steril
Duk steril
Sarung tangan steril
Bak kecil steril
Mangkuk kecil steril
Klem
Plester
Desinfektan (alcohol + bethadine)
Gelas ukur (mat kan)
Timbangan BB
Formulir hemodialisis
Sirkulasi darah
Cuci tangan
Letakkan GB pada holder, dengan posisi merah diatas
Hubungkan ujung putih pada ABL dengan GB ujung merah
Hubungkan ujung putih VBL dengan GB ujung biru, ujung biru VBL dihubungkan dengan alat penampung/ mat-kan
Letakkan posisi GB terbalik, yaitu yang tanda merah dibawah, biru diatas
Gantungkan NaCl 0,9 % (2-3 kolf)
Pasang infus set pada kolf NaCl
Hubungkan ujung infus set dengan ujung merah ABL atau tempat khusus
Tutup semua klem yang ada pada slang ABL, VBL, (untuk hubungan tekanan arteri, tekanan vena, pemberian obat-obatan)
Buka klem ujung dari ABL, VBL dan infus set
Jalankan Qb dengan kecepatan kurang lebih 100 ml/m
Udara yang ada dalam GB harus hilang (sampai bebeas udara) dengan cara menekan-nekan VBL
Air trap/Bubble trap diisi 2/3-3/4 bagian
Setiap kolf NaCl sesudah/ hendak mengganti kolf baru Qb dimatikan
Setelah udara dalam GB habis, hubungkan ujung ABL dengan ujung VBL, klem tetap dilepas
Masukkan heparin dalam sirkulasi darah sebanyak 1500-2000 U
Ganti kolf NaCl dengan yang baru yang telah diberi heparin 500 U dan klem infus dibuka
Jalankan sirkulasi darah + soaking (melembabkan GB) selama 10-15 menit sebelu dihubungkan dengan sirkulasi sistemik (pasien)
CATATAN !!!!
PERSIAPAN SIRKULASI
Rinsing/Membilas GB + VBL + ABL
Priming/ mengisi GB + VBL + ABL
Soaking/ melembabkan GB.
Volume priming : darah yang berada dalam sirkulasi (ABL + GB + VBL )
Cara menghitung volume priming :
Σ NaCl yang dipakai membilas dikurangi jumlah NaCl yang ada didalam mat kan (gelas tampung/ ukur)
Contoh :
∑ NaCl yang dipakai membilas : 1000 cc
∑ NaCl yang ada didalam mat kan : 750 cc
Jadi volume priming : 1000 cc – 750 cc = 250 cc
Cara melembabkan (soaking) GB Yaitu dengan menghubungkan GB dengan sirkulasi dialisat
Bila mempergunakan dialyzer reuse / pemakaian GB ulang :
Buang formalin dari kompartemen darah dan kompartemen dialisat
Hubungkan dialyzer dengan selang dialisat Biarkan kurang lebih 15 menit pada posisi rinse
Test formalin dengan tablet clinitest :
Tampung cairan yang keluar dari dialyzer atau drain
Ambil cairan 10 tts (1/2 cc), masukkan ke dalam tabung gelas, masukkan 1 tablet clinitest ke dalam tabung gelas yang sudah berisi cairan
Lihat reaksi :
Warna biru : – / negatif
Warna hijau : + / positif
Warna kuning : + / positif
Warna coklat : +/ positif
Selanjutnya mengisi GB sesuai dengan cara mengisi GB baru
Persiapan pasien
1.Persiapan mental
2.Izin hemodialisis
3.Persiapan fisik :Timbang BB, Posisi, Observasi KU (ukur TTV)
2.PERAWATAN SELAMA HEMODIALISIS (INTRA HD)
Pasien
Sarana hubungan sirkulasi/ akses sirkulasi :
Dengan internal A-V shunt/ fistula cimino
Pasien sebelumnya dianjurkan cuci lengan & tangan
Teknik aseptic + antiseptic : bethadine + alcohol
Anestesi local (lidocain inj, procain inj)
Punksi vena (outlet). Dengan AV fistula no G.14 s/d G.16/ abocath, fiksasi, tutup dengan kasa steril
Berikan bolus heparin inj (dosis awal)
Punksi inlet (fistula), fiksasi, tutup dengan kassa steril
Dengan eksternal A-V shunt (Schibner)
Desinfektan
Klem kanula arteri & vena
Bolus heparin inj (dosis awal)
Tanpa 1 & 2 (femora dll)
Desinfektan
Anestesi local
Punksi outlet/ vena (salah satu vena yang besar, biasanya di lengan).
Bolus heparin inj (dosis awal)
Fiksasi, tutup kassa steril
Punksi inlet (vena/ arteri femoralis)
Raba arteri femoralis
Tekan arteri femoralis
Vena femoralis 0,5 – 1 cm ke arah medial
Anestesi lokal (infiltrasi anetesi)
Vena femoralis dipunksi setelah anestesi lokal 3-5 menit
Fiksasi
Tutup dengan kassa steril
Memulai hemodialisis
1.Ujung ABL line dihubungkan dengan punksi inlet
2.Ujung VBL line dihubungkan dengan punksi outlet
3.Semua klem dibuka, kecuali klem infus set
4.Jalankan pompa darah (blood pump) dengan Qb 100 ml/m, sampai sirkulasi darah terisi darah semua.
5.Pompa darah (blood pump stop, sambungkan ujung dari VBL dengan punksi outlet
6.Fiksasi ABL & VBL (sehingga pasien tidak sulit untuk bergerak)
7.cairan priming diampung di gelas ukur dan jumlahnya dicatat (cairan dikeluarkan sesuai kebutuhan).
8.Jalankan pompa darah dengan Qb = 100 ml/m, setelah 15 menit bisa dinaikkan sampai 300 ml/m (dilihat dari keadaan pasien)
9.Hubungkan selang-selang untuk monitor : venous pressure, arteri pressure, hidupkan air/ blood leak detector
10.Pompa heparin dijalankan (dosis heparin sesuai keperluan). Heparin dilarutkan dengan NaCl
11.Ukur TD, Nadi setiap 1 jam. Bila keadaan pasien tidak baik/ lemah lakukan mengukur TD, N, lebih sering.
12.Isi formulir HD antara lain : Nama, Umur, BB, TD, S, N, P, Tipe GB, Cairan priming yang masuk, makan/minum, keluhan selama HD, masalah selama HD.
CATATAN !!!!
1.Permulaan HD posisi dialyzer terbalik setelah dialyzer bebas udara posisi kembalikan ke posisi sebenarnya.
2.Pada waktu menghubungkan venous line dengan punksi outlet, udara harus diamankan lebih dulu
3.Semua sambungan dikencangkan
4.Tempat-tempat punksi harus harus sering dikontrol, untuk menghindari terjadi perdarahan dari tempat punksi.
Mesin
Memprogram mesin hemodialisis :
1.Qb : 200 – 300 ml/m
2.Qd : 300 – 500 ml/m
3.Temperatur : 36-400C
4.TMP. UFR
5.Heparinisasi
Tekanan (+) /venous pressure
Trans Membran Pressure / TMP Tekanan (-) / dialysate pressure
Tekanan (+) + tekanan (-)
Tekanan / pressure :
Arterial pressure / tekanan arteri : banyaknya darah yang keluar dari tubuh
Venous pressure / tekanan vena : lancar/ tidak darah yang masuk ke dalam.
Heparinisasi
Dosis heparin :
Dosis awal : 25 – 50 U/kg BB
Dosis selanjutnya (maintenance) = 500 – 1000 U/kg BB
Cara memberikan
Kontinus
Intermiten (biasa diberikan tiap 1 jam sampai 1 jam terakhir sebelum HD selesai)
Heparinisasi umum
Kontinus :
Dosis awal : ……. U
Dosis selanjutnya : …… U
Intermitten :
Dosis awal : …… U
Dosis selanjutnya : ……. U
Heparinisasi regional
Dosis awal : …… U
Dosis selanjutnya : ….. U
Protamin : …. U
Heparin : protamin = 100 U : 1 mg
Heparin & protamin dilarutkan dengan NaCl.
Heparin diberikan/ dipasang pada selang sebelum dializer.
Protamin diberikan/ dipasang pada selang sebelum masuk ke tubuh/ VBL.
Heparinisasi minimal
Syarat-syarat :
Dialyzer khusus (kalau ada).
Qb tinggi (250 – 300 ml/m)
Dosis heparin : 500 U (pada sirkulasi darah).
Bilas dengan NaCl setiap : ½ – 1 jam
Banyaknya NaCl yang masuk harus dihitung
Jumlahnya NaCl yang masuk harus dikeluarkan dari tubuh, bisa dimasukkan ke dalam program ultrafiltrasi
CATATAN
Dosis awal : diberikan pada waktu punksi : sirkulasi sistem
Dosis selanjutnya: diberikan dengan sirkulasi (maintenance) ekstra korporeal.
PENGAMATAN OBSERVASI, MONITOR SELAMA HEMODIALISA
1.PASIEN
KU pasien
TTV
Perdarahan
Tempat punksi inlet, outlet
Keluhan/ komplikasi hemodialisis
2.MESIN & PERALATAN
Qb
Qd
Temperature
Koduktiviti
Pressure/ tekanan : arterial, venous, dialysate, UFR
Air leak & Blood leak
Heparinisasi
Sirkulasi ekstra corporeal
Sambungan-sambungan
CATATAN :
Obat menaikkan TD ( tu. pend hipotensi berat) : Efedrin 1 ampul + 10 cc aquadest kmd disuntik 2 ml/IV
3.PERAWATAN SESUDAH HEMODIALISIS (POST HD)
Mengakhiri HD
-Persiapan alat :
-Kain kasa/ gaas steril
-Plester
-Verband gulung
-Alkohol/ bethadine
-Antibiotik powder (nebacetin/ cicatrin)
-Bantal pasir (1-1/2 keram) : pada punksi femoral
Cara bekerja
1.5 menit sebelum hemodialisis berakhir Qb diturunkan sekitar 100cc/m UFR = 0
2.Ukur TD, nadi
3.Blood pump stop
4.Ujung ABL diklem, jarum inlet dicabut , bekas punksi inlet ditekan dengan kassa steril yang diberi betadine.
5.Hubungkan ujung abl dengan infus set
6.Darah dimasukkan ke dalam tubuh dengan do dorong dengan nacl sambil qb dijalankan 100 ml/m (NaCl masuk : 50 – 100 cc)
7.Setelah darah masuk ke tubuh Blood pump stop, ujun VBL diklem.
8.Jarum outlet dicabut, bekas punksi inlet & outlet ditekan dengan kassa steril yang diberi bethadine
9.Bila perdarahan pada punksi sudah berhenti, bubuhi bekas punksi inlet & outlet dengan antibiotik powder, lalu tutup dengan kain kassa/band aid lalu pasang verband.
10.Ukur TTV : TD. N, S, P
11.Timbang BB (kalau memungkinkan)
12.Isi formulir hemodialisis
CATATAN :
1.Cairan pendorong/ pembilas (NaCl) sesuai dengan kebutuhan , kalau perlu di dorong dengan udara ( harus hati-hati)
2.Penekanan bekas punksi dengan 3 jari sekitar 10 menit
3.Bekas punksi femoral lebih lama, setelah perdarahan berhenti, ditekan kembali dengan bantal pasir
4.Bekas punksi arteri penekanan harus tepat, lebih lama
5.Memakai teknik aseptik dan antiseptik
SCRIBNER
1.Pakai sarung tangan
2.Sebelum ABL & VBL dilepas dari kanula maka kanula arteri & kanula vena harus diklem lebih dulu
3.kanula arteri & vena dibilas dengan NaCl yang diberi 2500 U – 300 U heparin inj
4.Kedua sisi kanula dihubungkan kembali dengan konektor
5.Lepas klem pada kedua kanula
6.Fiksasi
7.Pasang balutan dengan sedikit kanula bisa dilihat dari luar, untuk mengetahui ada bekuan atau tidak.
ASUHAN KEPERAWATAN PASIEN HEMODIALISIS
Pada pasien yang baru pertama kali hemodialisis, jika kondisi pasien memungkinkan, pasien diorientasikan pada ruangan paviliun II dan alat-alat yang ada. Selain itu pasien diberikan penjelasan ringkas tentang prosedur yang akan dijalankan, prinsip hemodialisis, diet, pembatasan cairan, perawatan cimino, hal-hal yang boleh dan tidak boleh dilakukan selama hemodialisis dan efek dari hemodialisis.
Pada pre hemodialisis, kegiatan perawatan meliputi : menghidupkan mesin, meyediakan alat-alat, memasang alat pada mesin, sirkulasi cairan NaCl pada mesin, mengawasi penimbangan berat badan pasien, mengukur suhu badan, mengukur tekanan darah dan menghitung denyut nadi.
Pada tahap pemasangan alat dan selama pemasangan, kegiatannya meliputi : desinfeksi daerah penusukan, pemberian anestesi lokal (kalau perlu), penusukan jarum, pemasukan heparin (bolus), selanjutnya menyambung jarum pada arteri blood line. Lalu menekan tombol BFR, membuka klem venous dan arteri blood line, memprogram penurunan berat badan, waktu pelaksanaan, venous pressure, kecepatan aliran heparin dan UFR. Kemudian menghubungkan heparin contnous ke sirkulasi, monitoring pernafasan, makan dan minum, pengaturan posisi tubuh, monitoring alat-alat dan kelancaran sirkulasi darah, mengukur tekanan darah dan menciptakan suasana ruangan untuk mengisi kegiatan pasien selama hemodialisis berlangsung.
Pada tahap penghentian hemodialisis meliputi : penghentian aliran darah, mencabut jarum inlet dan menekan bekas tusukan sambil menunggu sampai aliran darah pada venous blood line habis. Langkah selanjutnya adalah mencabut jarum out line dan menekan bekas tusukan, mengganti gaas bethadine dan fiksasi dengan plester. Setelah penghentian hemodialisis, dilakukan pengukuran tekanan darah, mengukur suhu, mengawasi penimbangan berat badan, membereskan alat-alat dan dilanjutkan dengan desinfeksi alat.
Semua kegiatan baik pada tahap pre hemodialisis selama pemasangan dan penghentian hemodialisis dilakukan oleh perawat kecuali penimbangan berat badan dan minum yang pada beberapa pasien dilakukan sendiri. Disamping itu beberapa pasien telah dapat melaporkan pada perawat apabila ada ketidakberesan pada mesin atau akses vaskular, setelah mencoba mengatasi sendiri.
Sistem pencatatan dan pelaporan yang dijalankan dalam bentuk lembaran observasi pasien yang berisi tentang : TTV sebelum atau selama dan sesudah HD, BB sebelum dan sesudah HD, dosis heparin, program penurunan BB , priming dan keluhan pasien setelah HD.
Pembuatan rencana perawatan pasien sudah berjalan dimana dalam pengkajian meliputi data fisik dan psikososial. Data psikososial yang dikaji sebatas pada adanya rasa cemas dan bosan. Intervensi keperawatan yang dilakukan mengarah kepada pemberian bantuan sepenuhnya. Hal ini dapat terlihat dari kegiatan :
a.Pada tahap persiapan
b.Pada tahap pelaksanaan
c.Pada tahap penghentian
disadur dari :
http://argakyo.blogspot.com
Thursday, March 18, 2010
INFO CPNS PEMDA 2010 , CPNS DEPARTEMEN 2010, CPNS BUMN 2010, CPNS POLRI 2010, CPNS TNI 2010, FORMASI CPNS PEMDA 2010 - 2011,FORMASI CPNS DEPARTEMEN 20
membantu meng- UPDATE PENERIMAAN CALON PEGAWAI NEGERI SIPIL ( CPNS ) di lingkungan pemerintah daerah, pemerintah kota, departemen, BUMN, Polri dan TNI tahun 2010, silahkan anda memantau pada link yang akan saya berikan. semoga bermanfaat dan sukses untuk kalian semua.
semua KUMPULAN PENGUMUMAN CPNSD SEMUA PEMKOT DAN PEMDA 2010 - 2011 TERANGKUM DISINI
CPNS 2010 PEMERINTAH DAERAH ( PEMDA)dan PEMERINTAH KOTA ( PEMKOT )
PROVINSI ACEH
1 Kabupaten Aceh Barat
2 Kabupaten Aceh Barat Daya
3 Kabupaten Aceh Besar
4 Kabupaten Aceh Jaya
5 Kabupaten Aceh Selatan
6 Kabupaten Aceh Singkil
7 Kabupaten Aceh Tamiang
8 Kabupaten Aceh Tengah
9 Kabupaten Aceh Tenggara
10 Kabupaten Aceh Timur
11 Kabupaten Aceh Utara
12 Kabupaten Bener Meriah
13 Kabupaten Bireuen
14 Kabupaten Gayo Lues
15 Kabupaten Nagan Raya
16 Kabupaten Pidie
17 Kabupaten Pidie Jaya
18 Kabupaten Simeulue
19 Kota Banda Aceh
20 Kota Langsa
21 Kota Lhokseumawe
22 Kota Sabang
23 Kota Subulussalam
SUMATERA UTARA
No. Kabupaten/Kota
1 Kabupaten Asahan
2 Kabupaten Batubara
3 Kabupaten Dairi
4 Kabupaten Deli Serdang
5 Kabupaten Humbang Hasundutan
6 Kabupaten Karo
7 Kabupaten Labuhanbatu
8 Kabupaten Labuhanbatu Selatan
9 Kabupaten Labuhanbatu Utara
10 Kabupaten Langkat
11 Kabupaten Mandailing Natal
12 Kabupaten Nias
13 Kabupaten Nias Barat
14 Kabupaten Nias Selatan
15 Kabupaten Nias Utara
16 Kabupaten Padang Lawas
17 Kabupaten Padang Lawas Utara
18 Kabupaten Pakpak Bharat
19 Kabupaten Samosir
20 Kabupaten Serdang Bedagai
21 Kabupaten Simalungun
22 Kabupaten Tapanuli Selatan
23 Kabupaten Tapanuli Tengah
24 Kabupaten Tapanuli Utara
25 Kabupaten Toba Samosir
26 Kota Binjai
27 Kota Gunungsitoli
28 Kota Medan
29 Kota Padangsidempuan
30 Kota Pematangsiantar
31 Kota Sibolga
32 Kota Tanjungbalai
33 Kota Tebing Tinggi
SUMATERA BARAT
No. Kabupaten/Kota
1 Kabupaten Agam
2 Kabupaten Dharmasraya
3 Kabupaten Kepulauan Mentawai
4 Kabupaten Lima Puluh Kota
5 Kabupaten Padang Pariaman
6 Kabupaten Pasaman
7 Kabupaten Pasaman Barat
8 Kabupaten Pesisir Selatan
9 Kabupaten Sijunjung
10 Kabupaten Solok
11 Kabupaten Solok Selatan
12 Kabupaten Tanah Datar
13 Kota Bukittinggi
14 Kota Padang
15 Kota Padangpanjang
16 Kota Pariaman
17 Kota Payakumbuh
18 Kota Sawahlunto
19 Kota Solok
BENGKULU
Kabupaten Bengkulu Selatan
Kabupaten Bengkulu Tengah
Kabupaten Bengkulu Utara
Kabupaten Kaur
Kabupaten Kepahiang
Kabupaten Lebong
Kabupaten Mukomuko
Kabupaten Rejang Lebong
Kabupaten Seluma
Kota Bengkulu
JAMBI
Kabupaten Batanghari
Kabupaten Bungo
Kabupaten Kerinci
Kabupaten Merangin
Kabupaten Muaro Jambi
Kabupaten Sarolangun
Kabupaten Tanjung Jabung Barat
Kabupaten Tanjung Jabung Timur
Kabupaten Tebo
Kota Jambi
Kota Sungai Penuh
RIAU
Kabupaten Bengkalis
Kabupaten Indragiri Hilir
Kabupaten Indragiri Hulu
Kabupaten Kampar
Kabupaten Kuantan Singingi
Kabupaten Pelalawan
Kabupaten Rokan Hilir
Kabupaten Rokan Hulu
Kabupaten Siak
Kabupaten Kepulauan Meranti
Kota Dumai
Kota Pekanbaru
SUMATERA SELATAN
Kabupaten Banyuasin
Kabupaten Empat Lawang
Kabupaten Lahat
Kabupaten Muara Enim
Kabupaten Musi Banyuasin
Kabupaten Musi Rawas
Kabupaten Ogan Ilir
Kabupaten Ogan Komering Ilir
Kabupaten Ogan Komering Ulu
Kabupaten Ogan Komering Ulu Selatan
Kabupaten Ogan Komering Ulu Timur
Kota Lubuklinggau
Kota Pagar Alam
Kota Palembang
Kota Prabumulih
LAMPUNG
Kabupaten Lampung Barat
Kabupaten Lampung Selatan
Kabupaten Lampung Tengah
Kabupaten Lampung Timur
Kabupaten Lampung Utara
Kabupaten Mesuji
Kabupaten Pesawaran
Kabupaten Pringsewu
Kabupaten Tanggamus
Kabupaten Tulang Bawang
Kabupaten Tulang Bawang Barat
Kabupaten Way Kanan
Kota Bandar Lampung
Kota Metro
KEPULAUAN BANGKA BELITUNG
Kabupaten Bangka
Kabupaten Bangka Barat
Kabupaten Bangka Selatan
Kabupaten Bangka Tengah
Kabupaten Belitung
Kabupaten Belitung Timur
Kota Pangkal Pinang
KEPULAUAN RIAU
Kabupaten Bintan
Kabupaten Karimun
Kabupaten Kepulauan Anambas
Kabupaten Lingga
Kabupaten Natuna
Kota Batam
Kota Tanjung Pinang
BANTEN
Kabupaten Lebak
Kabupaten Pandeglang
Kabupaten Serang
Kabupaten Tangerang
Kota Cilegon
Kota Serang
Kota Tangerang
Kota Tangerang Selatan
JAWA BARAT
Kabupaten Bandung
Kabupaten Bandung Barat
Kabupaten Bekasi
Kabupaten Bogor
Kabupaten Ciamis
Kabupaten Cianjur
Kabupaten Cirebon
Kabupaten Garut
Kabupaten Indramayu
Kabupaten Karawang
Kabupaten Kuningan
Kabupaten Majalengka
Kabupaten Purwakarta
Kabupaten Subang
Kabupaten Sukabumi
Kabupaten Sumedang
Kabupaten Tasikmalaya
Kota Bandung
Kota Banjar
Kota Bekasi
Kota Bogor
Kota Cimahi
Kota Cirebon
Kota Depok
Kota Sukabumi
Kota Tasikmalaya
DKI JAKARTA
Kabupaten Administrasi Kepulauan Seribu
Kota Administrasi Jakarta Barat
Kota Administrasi Jakarta Pusat
Kota Administrasi Jakarta Selatan
Kota Administrasi Jakarta Timur
Kota Administrasi Jakarta Utara
JAWA TENGAH
Kabupaten Banjarnegara
Kabupaten Banyumas
Kabupaten Batang
Kabupaten Blora
Kabupaten Boyolali
Kabupaten Brebes
Kabupaten Cilacap
Kabupaten Demak
Kabupaten Grobogan
Kabupaten Jepara
Kabupaten Karanganyar
Kabupaten Kebumen
Kabupaten Kendal
Kabupaten Klaten
Kabupaten Kudus
Kabupaten Magelang
Kabupaten Pati
Kabupaten Pekalongan
Kabupaten Pemalang
Kabupaten Purbalingga
Kabupaten Purworejo
Kabupaten Rembang
Kabupaten Semarang
Kabupaten Sragen
Kabupaten Sukoharjo
Kabupaten Tegal
Kabupaten Temanggung
Kabupaten Wonogiri
Kabupaten Wonosobo
Kota Magelang
Kota Pekalongan
Kota Salatiga
Kota Semarang
Kota Surakarta
Kota Tegal
JAWA TIMUR
Kabupaten Bangkalan
Kabupaten Banyuwangi
Kabupaten Blitar
Kabupaten Bojonegoro
Kabupaten Bondowoso
Kabupaten Gresik
Kabupaten Jember
Kabupaten Jombang
Kabupaten Kediri
Kabupaten Lamongan
Kabupaten Lumajang
Kabupaten Madiun
Kabupaten Magetan
Kabupaten Malang
Kabupaten Mojokerto
Kabupaten Nganjuk
Kabupaten Ngawi
Kabupaten Pacitan
Kabupaten Pamekasan
Kabupaten Pasuruan
Kabupaten Ponorogo
Kabupaten Probolinggo
Kabupaten Sampang
Kabupaten Sidoarjo
Kabupaten Situbondo
Kabupaten Sumenep
Kabupaten Trenggalek
Kabupaten Tuban
Kabupaten Tulungagung
Kota Batu[8]
Kota Blitar
Kota Kediri
Kota Madiun
Kota Malang
Kota Mojokerto
Kota Pasuruan
Kota Probolinggo
Kota Surabaya
BALI
Kabupaten Badung
Kabupaten Bangli
Kabupaten Buleleng
Kabupaten Gianyar
Kabupaten Jembrana
Kabupaten Karangasem
Kabupaten Klungkung
Kabupaten Tabanan
Kota Denpasar
NUSA TENGGARA BARAT
Kabupaten Bima
Kabupaten Dompu
Kabupaten Lombok Barat
Kabupaten Lombok Tengah
Kabupaten Lombok Timur
Kabupaten Lombok Utara
Kabupaten Sumbawa
Kabupaten Sumbawa Barat
Kota Bima
Kota Mataram
NUSA TENGGARA TIMUR
Kabupaten Alor
Kabupaten Belu
Kabupaten Ende
Kabupaten Flores Timur
Kabupaten Kupang
Kabupaten Lembata
Kabupaten Manggarai
Kabupaten Manggarai Barat
Kabupaten Manggarai Timur
Kabupaten Ngada
Kabupaten Nagekeo
Kabupaten Rote Ndao
Kabupaten Sabu Raijua
Kabupaten Sikka
Kabupaten Sumba Barat
Kabupaten Sumba Barat Daya
Kabupaten Sumba Tengah
Kabupaten Sumba Timur
Kabupaten Timor Tengah Selatan
Kabupaten Timor Tengah Utara
Kota Kupang
KALIMANTAN BARAT
Kabupaten Bengkayang
Kabupaten Kapuas Hulu
Kabupaten Kayong Utara
Kabupaten Ketapang
Kabupaten Kubu Raya
Kabupaten Landak
Kabupaten Melawi
Kabupaten Pontianak
Kabupaten Sambas
Kabupaten Sanggau
Kabupaten Sekadau
Kabupaten Sintang
Kota Pontianak
Kota Singkawang
KALIMANTAN SELATAN
Kabupaten Balangan
Kabupaten Banjar
Kabupaten Barito Kuala
Kabupaten Hulu Sungai Selatan
Kabupaten Hulu Sungai Tengah
Kabupaten Hulu Sungai Utara
Kabupaten Kotabaru
Kabupaten Tabalong
Kabupaten Tanah Bumbu
Kabupaten Tanah Laut
Kabupaten Tapin
Kota Banjarbaru
Kota Banjarmasin
KALIMANTAN TENGAH
Kabupaten Barito Selatan
Kabupaten Barito Timur
Kabupaten Barito Utara
Kabupaten Gunung Mas
Kabupaten Kapuas
Kabupaten Katingan
Kabupaten Kotawaringin Barat
Kabupaten Kotawaringin Timur
Kabupaten Lamandau
Kabupaten Murung Raya
Kabupaten Pulang Pisau
Kabupaten Sukamara
Kabupaten Seruyan
Kota Palangka Raya
KALIMANTAN TIMUR
Kabupaten Berau
Kabupaten Bulungan
Kabupaten Kutai Barat
Kabupaten Kutai Kartanegara
Kabupaten Kutai Timur
Kabupaten Malinau
Kabupaten Nunukan
Kabupaten Paser
Kabupaten Penajam Paser Utara
Kabupaten Tana Tidung
Kota Balikpapan
Kota Bontang
Kota Samarinda
Kota Tarakan
GORONTALO
Kabupaten Boalemo
Kabupaten Bone Bolango
Kabupaten Gorontalo
Kabupaten Gorontalo Utara
Kabupaten Pohuwato
Kota Gorontalo
SULAWESI SELATAN
Kabupaten Bantaeng
Kabupaten Barru
Kabupaten Bone
Kabupaten Bulukumba
Kabupaten Enrekang
Kabupaten Gowa
Kabupaten Jeneponto
Kabupaten Kepulauan Selayar
Kabupaten Luwu
Kabupaten Luwu Timur
Kabupaten Luwu Utara
Kabupaten Maros
Kabupaten Pangkajene dan Kepulauan
Kabupaten Pinrang
Kabupaten Sidenreng Rappang
Kabupaten Sinjai
Kabupaten Soppeng
Kabupaten Takalar
Kabupaten Tana Toraja
Kabupaten Toraja Utara
Kabupaten Wajo
Kota Makassar
Kota Palopo
Kota Parepare
SULAWESI TENGGARA
Kabupaten Bombana
Kabupaten Buton
Kabupaten Buton Utara
Kabupaten Kolaka
Kabupaten Kolaka Utara
Kabupaten Konawe
Kabupaten Konawe Selatan
Kabupaten Konawe Utara
Kabupaten Muna
Kabupaten Wakatobi
Kota Bau-Bau
Kota Kendari
SULAWESI TENGAH
Kabupaten Banggai
Kabupaten Banggai Kepulauan
Kabupaten Buol
Kabupaten Donggala
Kabupaten Morowali
Kabupaten Parigi Moutong
Kabupaten Poso
Kabupaten Tojo Una-Una
Kabupaten Toli-Toli
Kabupaten Sigi
Kota Palu
SULAWESI UTARA
Kabupaten Bolaang Mongondow
Kabupaten Bolaang Mongondow Selatan
Kabupaten Bolaang Mongondow Timur
Kabupaten Bolaang Mongondow Utara
Kabupaten Kepulauan Sangihe
Kabupaten Kepulauan Siau Tagulandang Biaro
Kabupaten Kepulauan Talaud
Kabupaten Minahasa
Kabupaten Minahasa Selatan
Kabupaten Minahasa Tenggara
Kabupaten Minahasa Utara
Kota Bitung
Kota Kotamobagu
Kota Manado
Kota Tomohon
SULAWESI BARAT
Kabupaten Majene
Kabupaten Mamasa
Kabupaten Mamuju
Kabupaten Mamuju Utara
Kabupaten Polewali Mandar
MALUKU
Kabupaten Buru
Kabupaten Buru Selatan
Kabupaten Kepulauan Aru
Kabupaten Maluku Barat Daya
Kabupaten Maluku Tengah
Kabupaten Maluku Tenggara
Kabupaten Maluku Tenggara Barat
Kabupaten Seram Bagian Barat
Kabupaten Seram Bagian Timur
Kota Ambon
Kota Tual
MALUKU UTARA
Kabupaten Halmahera Barat
Kabupaten Halmahera Tengah
Kabupaten Halmahera Utara
Kabupaten Halmahera Selatan
Kabupaten Kepulauan Sula
Kabupaten Halmahera Timur
Kabupaten Pulau Morotai
Kota Ternate
Kota Tidore Kepulauan
PAPUA
Kabupaten Asmat
Kabupaten Biak Numfor
Kabupaten Boven Digoel
Kabupaten Deiyai
Kabupaten Dogiyai
Kabupaten Intan Jaya
Kabupaten Jayapura
Kabupaten Jayawijaya
Kabupaten Keerom
Kabupaten Kepulauan Yapen
Kabupaten Lanny Jaya
Kabupaten Mamberamo Raya
Kabupaten Mamberamo Tengah
Kabupaten Mappi
Kabupaten Merauke
Kabupaten Mimika
Kabupaten Nabire
Kabupaten Nduga
Kabupaten Paniai
Kabupaten Pegunungan Bintang
Kabupaten Puncak
DI. YOGYAKARTA
KOTA JOGJA
PEMDA DIY
PEMDA GUNUNGKIDUL
PEMDA BANTUL
PEMDA SLEMAN
PEMDA KULONPROGO
CPNS DEPARTEMEN 2010 - 2011
Departemen Agama (Depag)
Departemen Dalam Negeri
Departemen Energi&Sumber Daya Mineral
Departemen Luar Negeri (Deplu)
Departemen Hukum Dan Hak Asasi Manusia
Departemen Kehutanan (Dephut)
Departemen Kesehatan (Depkes)
Departemen Keuangan (Depkeu)
Departemen Kelautan Dan Perikanan
Departemen Kebudayaan Dan Pariwisata
Departemen Komunikasi Dan Informatika (Depkominfo)
Departemen Pekerjaan Umum
Departemen Perhubungan (Dephub)
Departemen Pendidikan Nasional (Depdiknas)
Departemen Perdagangan (Depdag)
Departemen Pertanian (Deptan)
Departemen Pertahanan (Dephan)
Departemen Perindustrian
Departemen Sosial (Depsos)
Departemen Tenaga Kerja Dan Transmigrasi
CPNS DEPARTEMEN, CPNS KEMENTERIAN CPNS BADAN
BADAN KOORDINASI KELUARGA BERENCANA
BADAN KOORDINASI SURVEI DAN PEMETAAN NASIONAL
BADAN NARKOTIKA NASIONAL
BADAN PEMERIKSA KEUANGAN
BADAN PERTANAHAN NASIONAL
BADAN PUSAT STATISTIK
BADAN STANDARDISASI NASIONAL
BANK INDONESIA
BAPETEN ( BADAN PENGAWAS TENAGA NUKLIR )
BATAN ( BADAN TENAGA NUKLIR NASIONAL )
BKKBN ( BADAN KOORDINASI KELUARGA BERENCANA NASIONAL )
BKN ( BADAN KEPEGAWAIAN NASIONAL )
BKPM ( BADAN KOORDINASI PENANAMAN MODAL )
BNPB ( BADAN NASIONAL PENANGGULANGAN BENCANA )
BPK ( BADAN PEMERIKSA KEUANGAN )
BPOM ( BADAN PENGAWAS OBAT DAN MAKANAN )
BPPT ( BADAN PENGKAJIAN DAN PENERAPAN TEKNOLOGI )
BADAN STANDARISASI NASIONAL
BIN
BMKG ( BADAN METEOROLOGI KLIMATOLOGI DAN GEOFISIKA )
BPKP ( BADAN PENGAWASAN KEUANGAN DAN PEMBANGUNAN )
BPN2TKI
BPPT ( BADAN PENGKAJIAN DAN PENERAPAN TEKNOLOGI )
BPS ( BIRO PUSAT STATISTIK )
BUPAR ( KEMENTERIAN BUDAYA DAN PARIWISATA )
ESDM ( KEMENTERIAN ENERGI DAN SUMBER DAYA MINERAL )
KEMENAG ( KEMENTERIAN AGAMA )
KEMENPORA ( KEMENTERIAN PEMUDA DAN OLAHRAGA )
KLH ( KEMETERIAN LINGKUNGAN HIDUP )
KOPERASI ( KEMENTERIAN KOPERASI DAN USAHA KECIL DAN MENENGAH )
LAN ( LEMBAGA ADMINISTRASI NEGARA )
MAHKAMAH KONSTITUSI
PU ( KEMENTERIAN PEKERJAAN UMUM )
KEMENTERIAN PEMBERDAYAAN PEREMPUAN DAN ANAK
DEPHAN ( DEPARTEMEN PERTANAHAN )
DEPTAN ( DEPARTEMEN PERTANIAN )
POLRI ( KEPOLISIAN NEGARA REPUBLIK INDONESIA )
SAR ( BADAN SAR NASIONAL INDONESIA )
KEMENTERIAN TENAGA KERJA DAN TRANSMIGRASI
TNI
DEPAG ( DEPARTEMEN AGAMA )
DEPKEU ( DEPARTEMEN KEUANGAN )
DEPARTEMEN PERDAGANGAN
DEPHAN
DEPKES
DEPKOMINFO ( DEPARTEMEN KOMUNIKASI DAN INFORMASI )
DEPLU ( DEPARTEMEN LUAR NEGERI )
DEPSOS ( DEPARTEMEN SOSIAL )
DKP ( DEPARTEMEN KELAUTAN DAN PERIKANAN )
ESDM ( KEMENTERIAN ENERGI DAN SUMBERDAYA MINERAL )
KEJAKSAAN AGUNG
KEMENKUMHAM ( KEMENTERIAN HUKUM DAN HAK ASASI MANUSIA )
DEPDAGRI ( KEMENTERIAN DALAM NEGERI )
KEMENTERIAN HUKUM DAN HAM
DEPHUT (KEMENTERIAN KEHUTANAN )
PU ( KEMENTERIAN PEKERJAAN UMUM )
KEMDIKNAS ( KEMENTERIAN PENDIDIKAN NASIONAL )
DEPHUB (KEMENTERIAN PERHUBUNGAN )
RISTEK ( KEMENTERIAN RISET DAN TEKNOLOGI )
DEPSOS ( KEMENTERIAN SOSIAL )
DEPKEU ( KEMENTRIAN KEUANGAN )
KEPOLISIAN
KOMNASHAM ( KOMISI NASIONAL HAK ASASI MANUSIA )
KOORDINATOR BIDANG KESEJAHTERAAN RAKYAT
LAPAN ( LEMBAGA PENERBANGAN DAN ANTARIKSA NASIONAL )
LAPAN ( LEMBAGA ADMINISTRASI NEGARA )
LEMHANAS ( LEMBAGA KETAHANAN NASIONAL )
LEMSANEG ( LEMBAGA SANDI NEGARA )
LIPI ( LEMBAGA ILMU PENGETAHUAN INDONESIA )
LKPP ( LEMBAGA KEBIJAKAN PENGADAAN BARANG / JASA PEMERINTAH )
LPBD-KUMKM ( LEMBAGA PENGELOLA DANA BERGULIR KOPERASI DAN USAHA MIKRO, KECIL DAN MENENGAH )
MAHKAMAH AGUNG
MAHKAMAH KONSTITUSI
MENKOKESRA ( KEMENTERIAN KOORDINATOR BIDANG KESEJAHTERAAN RAKYAT )
PEMBERDAYAAN PEREMPUAN DAN PERLINDUNGAN ANAK
KEMENPERA ( PERUMAHAN RAKYAT )
PPATK ( PUSAT PELAPORAN DAN ANALISIS TRANSAKSI KEUANGAN )
RISTEK
SEKRETARIAT JENDERAL KOMISI YUDISIAL
SETJEN MPR
SETNEG ( SEKERTARIAT NEGARA )
semua KUMPULAN PENGUMUMAN CPNSD SEMUA PEMKOT DAN PEMDA 2010 - 2011 TERANGKUM DISINI
CPNS 2010 PEMERINTAH DAERAH ( PEMDA)dan PEMERINTAH KOTA ( PEMKOT )
PROVINSI ACEH
1 Kabupaten Aceh Barat
2 Kabupaten Aceh Barat Daya
3 Kabupaten Aceh Besar
4 Kabupaten Aceh Jaya
5 Kabupaten Aceh Selatan
6 Kabupaten Aceh Singkil
7 Kabupaten Aceh Tamiang
8 Kabupaten Aceh Tengah
9 Kabupaten Aceh Tenggara
10 Kabupaten Aceh Timur
11 Kabupaten Aceh Utara
12 Kabupaten Bener Meriah
13 Kabupaten Bireuen
14 Kabupaten Gayo Lues
15 Kabupaten Nagan Raya
16 Kabupaten Pidie
17 Kabupaten Pidie Jaya
18 Kabupaten Simeulue
19 Kota Banda Aceh
20 Kota Langsa
21 Kota Lhokseumawe
22 Kota Sabang
23 Kota Subulussalam
SUMATERA UTARA
No. Kabupaten/Kota
1 Kabupaten Asahan
2 Kabupaten Batubara
3 Kabupaten Dairi
4 Kabupaten Deli Serdang
5 Kabupaten Humbang Hasundutan
6 Kabupaten Karo
7 Kabupaten Labuhanbatu
8 Kabupaten Labuhanbatu Selatan
9 Kabupaten Labuhanbatu Utara
10 Kabupaten Langkat
11 Kabupaten Mandailing Natal
12 Kabupaten Nias
13 Kabupaten Nias Barat
14 Kabupaten Nias Selatan
15 Kabupaten Nias Utara
16 Kabupaten Padang Lawas
17 Kabupaten Padang Lawas Utara
18 Kabupaten Pakpak Bharat
19 Kabupaten Samosir
20 Kabupaten Serdang Bedagai
21 Kabupaten Simalungun
22 Kabupaten Tapanuli Selatan
23 Kabupaten Tapanuli Tengah
24 Kabupaten Tapanuli Utara
25 Kabupaten Toba Samosir
26 Kota Binjai
27 Kota Gunungsitoli
28 Kota Medan
29 Kota Padangsidempuan
30 Kota Pematangsiantar
31 Kota Sibolga
32 Kota Tanjungbalai
33 Kota Tebing Tinggi
SUMATERA BARAT
No. Kabupaten/Kota
1 Kabupaten Agam
2 Kabupaten Dharmasraya
3 Kabupaten Kepulauan Mentawai
4 Kabupaten Lima Puluh Kota
5 Kabupaten Padang Pariaman
6 Kabupaten Pasaman
7 Kabupaten Pasaman Barat
8 Kabupaten Pesisir Selatan
9 Kabupaten Sijunjung
10 Kabupaten Solok
11 Kabupaten Solok Selatan
12 Kabupaten Tanah Datar
13 Kota Bukittinggi
14 Kota Padang
15 Kota Padangpanjang
16 Kota Pariaman
17 Kota Payakumbuh
18 Kota Sawahlunto
19 Kota Solok
BENGKULU
Kabupaten Bengkulu Selatan
Kabupaten Bengkulu Tengah
Kabupaten Bengkulu Utara
Kabupaten Kaur
Kabupaten Kepahiang
Kabupaten Lebong
Kabupaten Mukomuko
Kabupaten Rejang Lebong
Kabupaten Seluma
Kota Bengkulu
JAMBI
Kabupaten Batanghari
Kabupaten Bungo
Kabupaten Kerinci
Kabupaten Merangin
Kabupaten Muaro Jambi
Kabupaten Sarolangun
Kabupaten Tanjung Jabung Barat
Kabupaten Tanjung Jabung Timur
Kabupaten Tebo
Kota Jambi
Kota Sungai Penuh
RIAU
Kabupaten Bengkalis
Kabupaten Indragiri Hilir
Kabupaten Indragiri Hulu
Kabupaten Kampar
Kabupaten Kuantan Singingi
Kabupaten Pelalawan
Kabupaten Rokan Hilir
Kabupaten Rokan Hulu
Kabupaten Siak
Kabupaten Kepulauan Meranti
Kota Dumai
Kota Pekanbaru
SUMATERA SELATAN
Kabupaten Banyuasin
Kabupaten Empat Lawang
Kabupaten Lahat
Kabupaten Muara Enim
Kabupaten Musi Banyuasin
Kabupaten Musi Rawas
Kabupaten Ogan Ilir
Kabupaten Ogan Komering Ilir
Kabupaten Ogan Komering Ulu
Kabupaten Ogan Komering Ulu Selatan
Kabupaten Ogan Komering Ulu Timur
Kota Lubuklinggau
Kota Pagar Alam
Kota Palembang
Kota Prabumulih
LAMPUNG
Kabupaten Lampung Barat
Kabupaten Lampung Selatan
Kabupaten Lampung Tengah
Kabupaten Lampung Timur
Kabupaten Lampung Utara
Kabupaten Mesuji
Kabupaten Pesawaran
Kabupaten Pringsewu
Kabupaten Tanggamus
Kabupaten Tulang Bawang
Kabupaten Tulang Bawang Barat
Kabupaten Way Kanan
Kota Bandar Lampung
Kota Metro
KEPULAUAN BANGKA BELITUNG
Kabupaten Bangka
Kabupaten Bangka Barat
Kabupaten Bangka Selatan
Kabupaten Bangka Tengah
Kabupaten Belitung
Kabupaten Belitung Timur
Kota Pangkal Pinang
KEPULAUAN RIAU
Kabupaten Bintan
Kabupaten Karimun
Kabupaten Kepulauan Anambas
Kabupaten Lingga
Kabupaten Natuna
Kota Batam
Kota Tanjung Pinang
BANTEN
Kabupaten Lebak
Kabupaten Pandeglang
Kabupaten Serang
Kabupaten Tangerang
Kota Cilegon
Kota Serang
Kota Tangerang
Kota Tangerang Selatan
JAWA BARAT
Kabupaten Bandung
Kabupaten Bandung Barat
Kabupaten Bekasi
Kabupaten Bogor
Kabupaten Ciamis
Kabupaten Cianjur
Kabupaten Cirebon
Kabupaten Garut
Kabupaten Indramayu
Kabupaten Karawang
Kabupaten Kuningan
Kabupaten Majalengka
Kabupaten Purwakarta
Kabupaten Subang
Kabupaten Sukabumi
Kabupaten Sumedang
Kabupaten Tasikmalaya
Kota Bandung
Kota Banjar
Kota Bekasi
Kota Bogor
Kota Cimahi
Kota Cirebon
Kota Depok
Kota Sukabumi
Kota Tasikmalaya
DKI JAKARTA
Kabupaten Administrasi Kepulauan Seribu
Kota Administrasi Jakarta Barat
Kota Administrasi Jakarta Pusat
Kota Administrasi Jakarta Selatan
Kota Administrasi Jakarta Timur
Kota Administrasi Jakarta Utara
JAWA TENGAH
Kabupaten Banjarnegara
Kabupaten Banyumas
Kabupaten Batang
Kabupaten Blora
Kabupaten Boyolali
Kabupaten Brebes
Kabupaten Cilacap
Kabupaten Demak
Kabupaten Grobogan
Kabupaten Jepara
Kabupaten Karanganyar
Kabupaten Kebumen
Kabupaten Kendal
Kabupaten Klaten
Kabupaten Kudus
Kabupaten Magelang
Kabupaten Pati
Kabupaten Pekalongan
Kabupaten Pemalang
Kabupaten Purbalingga
Kabupaten Purworejo
Kabupaten Rembang
Kabupaten Semarang
Kabupaten Sragen
Kabupaten Sukoharjo
Kabupaten Tegal
Kabupaten Temanggung
Kabupaten Wonogiri
Kabupaten Wonosobo
Kota Magelang
Kota Pekalongan
Kota Salatiga
Kota Semarang
Kota Surakarta
Kota Tegal
JAWA TIMUR
Kabupaten Bangkalan
Kabupaten Banyuwangi
Kabupaten Blitar
Kabupaten Bojonegoro
Kabupaten Bondowoso
Kabupaten Gresik
Kabupaten Jember
Kabupaten Jombang
Kabupaten Kediri
Kabupaten Lamongan
Kabupaten Lumajang
Kabupaten Madiun
Kabupaten Magetan
Kabupaten Malang
Kabupaten Mojokerto
Kabupaten Nganjuk
Kabupaten Ngawi
Kabupaten Pacitan
Kabupaten Pamekasan
Kabupaten Pasuruan
Kabupaten Ponorogo
Kabupaten Probolinggo
Kabupaten Sampang
Kabupaten Sidoarjo
Kabupaten Situbondo
Kabupaten Sumenep
Kabupaten Trenggalek
Kabupaten Tuban
Kabupaten Tulungagung
Kota Batu[8]
Kota Blitar
Kota Kediri
Kota Madiun
Kota Malang
Kota Mojokerto
Kota Pasuruan
Kota Probolinggo
Kota Surabaya
BALI
Kabupaten Badung
Kabupaten Bangli
Kabupaten Buleleng
Kabupaten Gianyar
Kabupaten Jembrana
Kabupaten Karangasem
Kabupaten Klungkung
Kabupaten Tabanan
Kota Denpasar
NUSA TENGGARA BARAT
Kabupaten Bima
Kabupaten Dompu
Kabupaten Lombok Barat
Kabupaten Lombok Tengah
Kabupaten Lombok Timur
Kabupaten Lombok Utara
Kabupaten Sumbawa
Kabupaten Sumbawa Barat
Kota Bima
Kota Mataram
NUSA TENGGARA TIMUR
Kabupaten Alor
Kabupaten Belu
Kabupaten Ende
Kabupaten Flores Timur
Kabupaten Kupang
Kabupaten Lembata
Kabupaten Manggarai
Kabupaten Manggarai Barat
Kabupaten Manggarai Timur
Kabupaten Ngada
Kabupaten Nagekeo
Kabupaten Rote Ndao
Kabupaten Sabu Raijua
Kabupaten Sikka
Kabupaten Sumba Barat
Kabupaten Sumba Barat Daya
Kabupaten Sumba Tengah
Kabupaten Sumba Timur
Kabupaten Timor Tengah Selatan
Kabupaten Timor Tengah Utara
Kota Kupang
KALIMANTAN BARAT
Kabupaten Bengkayang
Kabupaten Kapuas Hulu
Kabupaten Kayong Utara
Kabupaten Ketapang
Kabupaten Kubu Raya
Kabupaten Landak
Kabupaten Melawi
Kabupaten Pontianak
Kabupaten Sambas
Kabupaten Sanggau
Kabupaten Sekadau
Kabupaten Sintang
Kota Pontianak
Kota Singkawang
KALIMANTAN SELATAN
Kabupaten Balangan
Kabupaten Banjar
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Tuesday, February 2, 2010
FIBIO ADENOMA MAMAE ( FAM )
FIBROADENOMA MAMMAE
Fibroadenoma mammae (FAM), umumnya menyerang para remaja dan wanita dengan usia di bawah 30 tahun. Adanya fibroadenoma atau yang biasa dikenal dengan tumor payudara membuat kaum wanita selalu cemas tentang keadaan pada dirinya. Terkadang mereka beranggapan bahwa tumor ini adalah sama dengan kanker. Yang perlu ditekankan adalah kecil kemungkinan dari fibroadenoma ini untuk menjadi kanker yang ganas. Di bawah ini saya akan membahas lebih lanjut tentang fibroadenoma mammae.
DEFINISI
Fibroadenoma mammae adalah tumor jinak yang paling sering terjadi pada wanita. Tumor ini terdiri dari gabungan antara kelenjar glandula dan fibrosa. Secara histologi:
intracanalicular fibroadenoma; fibroadenoma pada payudara yang secara tidak teratur dibentuk dari pemecahan antara stroma fibrosa yang mengandung serat jaringan epitel.
pericanalicular fibroadenoma; fibroadenoma pada payudara yang menyerupai kelenjar atau kista yang dilingkari oleh jaringan epitel pada satu atau banyak lapisan.
Tumor ini dibatasi letaknya dengan jaringan mammae oleh suatu jaringan penghubung.
Fibroadenoma mammae timbul akibat pengaruh kelebihan hormon estrogen.
Fibroadenoma mammae dibedakan menjadi 3 macam:
• Common Fibroadenoma
• Giant Fibroadenoma umumnya berdiameter lebih dari 5 cm.
• Juvenile fibroadenoma pada remaja.
PENYEBAB
Fibroadenoma ini terjadi akibat adanya kelebihan hormon estrogen. Biasanya ukurannya akan meningkat pada saat menstruasi atau pada saat hamil karena produksi hormon estrogen meningkat.
GEJALA
Pertumbuhan fibroadenoma mammae umumnya tidak menimbulkan rasa sakit, hanya ukuran dan tempat pertumbuhannya yang menyebabkan nyeri pada mammae. Pada saat disentuh kenyal seperti karet
PATOLOGI
Makroskopi: tampak bulat, elastis dan nodular, permukaan berwarna putih keabuan.
Mikroskopi: epitel proliferasi tampak seperti kelenjar yang dikelilingi oleh stroma fibroblastic yang khas (intracanalicular f. dan pericanalicular f.).
PENEGAKAN DIAGNOSA
Pada awalnya penegakan diagnosa tehadap fibroadenoma mammae ini adalah dilakukan pemeriksaan fisik, kemudian akan dilakukan mammogram (x-ray pada mammae) atau ultrasound pada mammae apabila diperlukan. Yang paling pasti dan tepat dalam diagnosa terhadap fibroadenoma mammae ini adalah penggunaan sample biopsi. Pengambilan sampel biopsi ini dapat dilakukan dengan mengiris bagian mammae atau dengan memasukkan jarum yang kecil dan panjang untuk mengambil sampel sel fibroadenoma tersebut.
Diagnosa terhadap FAM ini dapat dibuat dengan penggabungan penilaian klinis, ultrasonografi dan pengambilan sampel dengan penggunaan jarum. Penilaian klinis terhadap benjolan payudara ini harus mempertimbangkan:
• Umur:
Karsinoma: umumnya menyerang pada usia menjelang menopause
Fibroadenoma: umumnya menyerang wanita usia di bawah 30 tahun
TREATMENT
Karena FAM adalah tumor jinak maka pengobatan yang dilakukan tidak perlu dengan pengangkatan mammae. Yang perlu diperhatikan adalah bentuk dan ukurannya saja. Pengangkatan mammae harus memperhatikan beberapa faktor yaitu faktor fisik dan psikologi pasien. Apabila ukuran dan lokasi tumor tersebut menyebabkan rasa sakit dan tidak nyaman pada pasien maka diperlukan pengangkatan.
Taken from: http://fkuii.org/tiki-index.php?page=Fibroadenoma+mammae6
http://hijaupupus.multiply.com/reviews/item/22
Fibroadenoma mammae (FAM), umumnya menyerang para remaja dan wanita dengan usia di bawah 30 tahun. Adanya fibroadenoma atau yang biasa dikenal dengan tumor payudara membuat kaum wanita selalu cemas tentang keadaan pada dirinya. Terkadang mereka beranggapan bahwa tumor ini adalah sama dengan kanker. Yang perlu ditekankan adalah kecil kemungkinan dari fibroadenoma ini untuk menjadi kanker yang ganas. Di bawah ini saya akan membahas lebih lanjut tentang fibroadenoma mammae.
DEFINISI
Fibroadenoma mammae adalah tumor jinak yang paling sering terjadi pada wanita. Tumor ini terdiri dari gabungan antara kelenjar glandula dan fibrosa. Secara histologi:
intracanalicular fibroadenoma; fibroadenoma pada payudara yang secara tidak teratur dibentuk dari pemecahan antara stroma fibrosa yang mengandung serat jaringan epitel.
pericanalicular fibroadenoma; fibroadenoma pada payudara yang menyerupai kelenjar atau kista yang dilingkari oleh jaringan epitel pada satu atau banyak lapisan.
Tumor ini dibatasi letaknya dengan jaringan mammae oleh suatu jaringan penghubung.
Fibroadenoma mammae timbul akibat pengaruh kelebihan hormon estrogen.
Fibroadenoma mammae dibedakan menjadi 3 macam:
• Common Fibroadenoma
• Giant Fibroadenoma umumnya berdiameter lebih dari 5 cm.
• Juvenile fibroadenoma pada remaja.
PENYEBAB
Fibroadenoma ini terjadi akibat adanya kelebihan hormon estrogen. Biasanya ukurannya akan meningkat pada saat menstruasi atau pada saat hamil karena produksi hormon estrogen meningkat.
GEJALA
Pertumbuhan fibroadenoma mammae umumnya tidak menimbulkan rasa sakit, hanya ukuran dan tempat pertumbuhannya yang menyebabkan nyeri pada mammae. Pada saat disentuh kenyal seperti karet
PATOLOGI
Makroskopi: tampak bulat, elastis dan nodular, permukaan berwarna putih keabuan.
Mikroskopi: epitel proliferasi tampak seperti kelenjar yang dikelilingi oleh stroma fibroblastic yang khas (intracanalicular f. dan pericanalicular f.).
PENEGAKAN DIAGNOSA
Pada awalnya penegakan diagnosa tehadap fibroadenoma mammae ini adalah dilakukan pemeriksaan fisik, kemudian akan dilakukan mammogram (x-ray pada mammae) atau ultrasound pada mammae apabila diperlukan. Yang paling pasti dan tepat dalam diagnosa terhadap fibroadenoma mammae ini adalah penggunaan sample biopsi. Pengambilan sampel biopsi ini dapat dilakukan dengan mengiris bagian mammae atau dengan memasukkan jarum yang kecil dan panjang untuk mengambil sampel sel fibroadenoma tersebut.
Diagnosa terhadap FAM ini dapat dibuat dengan penggabungan penilaian klinis, ultrasonografi dan pengambilan sampel dengan penggunaan jarum. Penilaian klinis terhadap benjolan payudara ini harus mempertimbangkan:
• Umur:
Karsinoma: umumnya menyerang pada usia menjelang menopause
Fibroadenoma: umumnya menyerang wanita usia di bawah 30 tahun
TREATMENT
Karena FAM adalah tumor jinak maka pengobatan yang dilakukan tidak perlu dengan pengangkatan mammae. Yang perlu diperhatikan adalah bentuk dan ukurannya saja. Pengangkatan mammae harus memperhatikan beberapa faktor yaitu faktor fisik dan psikologi pasien. Apabila ukuran dan lokasi tumor tersebut menyebabkan rasa sakit dan tidak nyaman pada pasien maka diperlukan pengangkatan.
Taken from: http://fkuii.org/tiki-index.php?page=Fibroadenoma+mammae6
http://hijaupupus.multiply.com/reviews/item/22
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