ASUHAN KEPERAWATAN MEDIKAL BEDAH PADA TN. A DENGAN GANGGUAN SISTEM PERNAPASAN PADA EFUSI PLEURA DI RUMAH SAKIT VITA INSANI KOTA PEMATANGSIANTAR

Abstrak

Efusi pleura merupakan penumpukan cairan berlebih di rongga pleura yang menyebabkan sesak napas, batuk, dan nyeri dada. Menurut World Health Organization (WHO) tahun 2023, efusi pleura dialami sekitar 10–15 juta orang di dunia dengan angka kematian mencapai 100.000–250.000 kasus per tahun. Penelitian ini bertujuan menggambarkan asuhan keperawatan pada pasien efusi pleura. Penelitian ini menggunakan penelitian kualitatif dengan desain deskriptif melalui pendekatan studi kasus pada 1 responden, yaitu Tn. A, di Ruang Cendrawasih Rumah Sakit Vita Insani Pematangsiantar pada 29 Maret–1 April 2026. Instrumen penelitian meliputi format pengkajian, lembar observasi, catatan perkembangan, dan dokumentasi keperawatan.Tindakan keperawatan meliputi batuk efektif, posisi semi-Fowler, aromaterapi minyak kayu putih, pemantauan status pernapasan, edukasi, dan kolaborasi terapi. Setelah tiga hari perawatan, sesak napas dan sekret berkurang, saturasi oksigen meningkat, serta nyeri menurun. Asuhan keperawatan yang diberikan efektif dalam meningkatkan status pernapasan Tn. A, ditandai dengan jalan napas lebih bersih, pertukaran gas membaik, dan nyeri berkurang, dengan masalah keperawatan bersihan jalan nafas tidak efektif, gangguan pertukaran gas, dan masalah keperawatan nyeri akut teratasi sebagian.

Pleural effusion is the accumulation of excess fluid in the pleural cavity, causing shortness of breath, cough, and chest pain. According to the World Health Organization (WHO) in 2023, pleural effusion affects approximately 10–15 million people worldwide, with an estimated mortality rate of 100,000–250,000 cases annually. This study aimed to describe nursing care for patients with pleural effusion. This study employed a qualitative research design using a descriptive case study approach involving one respondent, Mr. A, in the Cendrawasih Ward at Vita Insani Hospital, from March 29 to April 1, 2026. The research instruments included a nursing assessment form, observation sheets, progress notes, and nursing documentation. Nursing interventions included effective coughing exercises, semi-Fowler's positioning, eucalyptus oil aromatherapy, respiratory status monitoring, health education, and collaborative therapy. After three days of care, dyspnea and sputum production decreased, oxygen saturation improved, and pain was reduced. Nursing care provided was effective in improving Mr. A's respiratory status, as evidenced by a clearer airway, improved gas exchange, and reduced pain. The nursing problems of ineffective airway clearance, impaired gas exchange, and acute pain were partially resolved.