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LAPORAN JAGA

TANGGAL 27 MARET 2016Disusun oleh:

Nely Halidiyah

Rino Riyadi

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! "# "denias

! Na$a : Tn#M

! %sia : 61 ahun

! Ruan&an : "GD

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! Ana$nesis 'Auoana$nesis(

! )eluhan %a$a : Nye*i +e*u ,anan -a.ah se/a, 2 ha*i

MR#

! )eluhan Ta$-ahan:

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RP :

! Pasien daan& ,e "GD R#POLR" den&an ,eluhan nye*i +e*u ,anan

-a.ah se/a, 2 ha*i MR# a,inya di*asa i-ai-a e*us $enea+

sa$+ai sei-anya di "GD R#Pol*i# Nye*i /u&a di*asa,an $en/ala* ,e

+e*u -a&ian en&ah dan ,e,e$aluan# Pasien $e*asa +e*unyase$a,in sa,i a+a-ila -au, aau -e*/alan# 3A3 dan 3A) no*$al

da*ah '( nye*i saa -e*,e$ih '(# De$a$ '( $ual dan $unah '(#

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! RPD! Tida, +e*nah $en&ala$i ,eluhan yan& sa$a se-elu$nya

! Gan&&uan 3A) disan&,al

! Hi+e*ensi disan&,al

! Dia-ees $elius disan&,al

!  Alle*&i disan&,al

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aus Gene*alis

! )% : Ta$+a, ,esa,ian

! )es : 4o$+os Menis

! TT5

! T : 1080 $$H&! N : 1009$eni

! : 674

! P : 2;9$eni

! )e+ala : no*$o<he+ali! Maa : )on/un&i=a Ane$is '( ,le*a ",e*i, '(

! Lehe* : Pe$-esa*an )G3 '(

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! Tho*a9

! Pul$o" : +e*&e*a,an dada si$e*is dala$ ,eadaan sais dan dina$is#

P : >*e$ius a,il ? =o,al si$e*is -ilae*al

P : sono* +ada ,edua la+an& +a*u

 A : sua*a na>as =esi,ule* @@ Rhon<i .heein&

! 4o* : s1s2 *e&ule* &allo+ '( $u*$u* '(

! A-do$en

" : daa* $assa '(

P: nye*i e,an '@( RLB de>ans $us,ula*'@(P: hy$+ani di ; ,uad*an a-do$en

 A: 3% '@( N

! E,s*e$ias : a,*al han&a 4RT C 2 dei,

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TAT% LO)AL"

! aus lo,alis a-do$en *e&io ,uad*an ,anan -a.ah:

! " : daa* $asa '( lesi '( hi+e*e$is '(

! P : $assa '( nye*i e,an '@( +ada ii, M< 3u*ney

de>ans $us,ula*'@( nye*i le+as '(! P : N)'@(

! A : 3% '@( N

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PEMER")AAN TAM3AHAN

! Psoas si&n '@(

! O-u*ao* si&n '(

! Ro=sin& si&n '(

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Pe$e*i,saan Penun/an&

5a*ia-el Te$uan Nilai No*$al

He$aolo&i

  H- 12&dl 121; &dl

Leu,osi 1#00ul 00010#000 ul

  H 7F 7;F

T*o$-osi ;#000ul 10#000;00#000ul

Masa Pe*da*ahan 10 16 $eni

Masa Pe$-e,uan 11 101 $eni

)i$ia )lini,

u*eu$ $&dl 100 $&dl

4*eainine 1; $&dl 01 $&dl

Glu,osa Da*ah 107 C1;0 $&dL

5a*ia-el Te$uan Nilai No*$al

URINELENGKAP

Ia*na ,unin&

Kejernihan )e*uh

Reaksi / PH #0 8#

Berat Jenis 1#00 1#0001#00

SedimenUrine

Leu,osi 2; LP3 0 LP3

E*i*osi 12 LP3 1 LP3

el e+iel @

ilinde*

)*isal  AMOR: @

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Dia&nosis

! Dia&nosis ,e*/a : A++endi<iis A,u

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Penaala,sanaan

Taala,sana! Ren<ana o+e*asi Pe*sia+an o+e*asi

! "5D RL 20 +$

! "n/ 4e>*ia9one 1K2 &* "5