PENERAPAN TERAPI POSISI SEMI FOWLER UNTUK MENGATASI MASALAH PENURUNAN CURAH JANTUNG PADA PASIEN DENGAN KARDIOMIOPATI DI RST BHAKTI WIRA TAMTAMA SEMARANG

Abstrak

Latar Belakang: Kardiomiopati merupakan kelainan otot jantung progresif yang mengganggu fungsi pompa mekanis, sehingga memicu masalah penurunan curah jantung. Penurunan curah jantung mengakibatkan hipoksia jaringan dan manifestasi kongestif seperti dispnea. Terapi non-farmakologis mandiri yang efektif untuk menurunkan beban jantung (preload) dan meningkatkan ekspansi paru adalah pengaturan posisi semi-Fowler. Tujuan: Mendeskripsikan pelaksanaan asuhan keperawatan komprehensif melalui penerapan terapi posisi semi-Fowler untuk mengatasi masalah penurunan curah jantung pada pasien kardiomiopati. Metode: Desain penelitian menggunakan studi kasus deskriptif pada dua pasien (Ny. G, 62 tahun dan Ny. J, 68 tahun) dengan diagnosis kardiomiopati di Ruang Cempaka RST Bhakti Wira Tamtama Semarang selama 3 hari perawatan. Hasil: Diagnosa keperawatan utama kedua pasien adalah penurunan curah jantung. Pada Ny. G, masalah berhubungan dengan perubahan afterload dan dinyatakan belum teratasi pada hari ketiga akibat adanya komplikasi perdarahan saluran cerna (muntah hitam). Pada Ny. J, masalah berhubungan dengan penurunan kontraktilitas dan dinyatakan teratasi ditandai dengan hilangnya sesak napas, tanda-tanda vital stabil (Nadi 88 x/menit, RR 22 x/menit), serta edema kaki minimal. Kesimpulan: Terapi posisi semi-Fowler (30°–45°) secara mekanis efektif menurunkan preload dan meningkatkan saturasi oksigen, namun keberhasilannya dipengaruhi oleh stabilitas klinis sistemik pasien.

Background: Cardiomyopathy is a progressive heart muscle disorder that impairs mechanical pump function, thereby triggering the problem of decreased cardiac output. Decreased cardiac output results in tissue hypoxia and congestive manifestations such as dyspnea. An effective independent non-pharmacological therapy to reduce cardiac workload (preload) and improve lung expansion is the adjustment of the semi-Fowler position. Objective: To describe the implementation of comprehensive nursing care through the application of semi-Fowler position therapy to overcome the problem of decreased cardiac output in cardiomyopathy patients. Method: This study used a descriptive case study design focusing on two patients (Mrs. G, 62 years old and Mrs. J, 68 years old) diagnosed with cardiomyopathy in the Cempaka Room at RST Bhakti Wira Tamtama Semarang during 3 days of care. Results: The primary nursing diagnosis for both patients was decreased cardiac output. In Mrs. G, the problem was related to altered afterload and was declared unresolved on the third day due to an acute complication of gastrointestinal bleeding (black vomitus). In Mrs. J, the problem was related to decreased contractility and was declared resolved, characterized by the resolution of dyspnea, stable vital signs (Pulse: 88 beats/minute, RR: 22 breaths/minute), and minimal leg edema. Conclusion: Semi-Fowler position therapy (30°–45°) is mechanically effective in reducing preload and increasing oxygen saturation; however, its success is highly influenced by the patient's systemic clinical stability.