Author Archive

Therapy for Diabetes Mellitus and Related Disorders (Clinical Education Series)

Powerful, practical treatment approaches proven to work. From guidelines for diagnosis and classification of diabetes, to pharmacological therapy, this handy reference will guide you through the treatment of specific problems important in the management of patients with diabetes. A practical resource with contributions from some of the most respected medical authorities, chapters cover such topics as genetic counseling, gestational diabetes, Lactic Acidosis, exercise, combination therapy for hyp

List Price: $ 49.95

Price: $ 15.00

[wprebay kw="diabetes+mellitus" num="0" ebcat="-1"] [wprebay kw="diabetes+mellitus" num="1" ebcat="-1"]

Teknik Akupresur pada Nyeri Persalinan

A. Pendahuluan

Nyeri persalinan merupakan pengalaman subjektif tentang sensasi fisik yang terkait dengan kontraksi uterus, dilatasi dan penipisan serviks, serta penurunan janin selama persalinan. Respon fisiologis terhadap nyeri meliputi peningkatan tekanan darah, denyut nadi, pernapasann, keringat, diameter pupil, dan ketegangan otot.
Berbagai upaya dilakukan untuk menurunkan nyeri pada persalinan, baik secara farmakologi maupun nonfarmakologi. Manajemen nyeri secara farmakologi lebih efektif dibanding dengan metode nonfarmakologi namun metode farmakologi lebih mahal, dan berpotensi mempunyai efek yang kurang baik ( Dickersin, 1989).
Sedangangkan metode nonfarmakologi bersifat nonintrusif, noinvasif, murah, simple, efektif dan tanpa efek yang merugikan (Burns & Blamey, 1994; Cook & Wilcox, 1997). Metode nonfarmakologi juga dapat meningkatkan kepuasan selama persalinan karena ibu dapat mengontrol perasaannya dan kekuatannya (Mackey,1995)

Relaksasi, teknik pernapasan, pergerakan dan perubahan posisi, massage, hidroterapi, terapi panas/dingin, musik, guided imagery, akupresur, aromaterapi merupakan beberapa teknik nonfarmakologi yang dapat meningkatkan kenyamanan ibu saat bersalin dan mempunyai pengaruh pada koping yang efektif terhadap pengalaman persalinan. Penelitian yang dilakukan oleh Sylvia T. Brown, EdD, RN, Carol Douglas, MSN, RN, and LeeAnn Plaster Flood, MSN, CNM pada tahun 2001, menggunakan 10 metode nonfarmakologi yang dilakukan pada sample 46 orang didapatkan bahwa teknik pernapasan, relaksasi, akupresur dan massage merupakan teknik yang paling efektif menurunkan nyeri saat persalinan.

Akupresur merupakan salah satu teknik nonfarmakologi yang paling efektif dalam manajemen nyeri persalinan. Akupresur disebut juga akupunktur tanpa jarum, atau pijat akupunktur. Teknik ini menggunakan tenik penekanan, pemijatan, dan pengurutan sepanjang meridian tubuh atau garis aliran energi. Teknik akupresur ini dapat menurunkan nyeri dan mengefektifkan waktu persalinan.

B. Teknik Akupresur pada Persalinan

Akupresur merupakan ilmu penyembuhan yang berasal dari Tionghoa sejak lebih dari 500 tahun yang lalu. Akupresur sebagai seni dan ilmu penyembuhan berlandaskan pada teori keseimbangan yang bersumber dari ajaran Taoisme. Taoisme mengajarkan bahwa semua isi alam raya dan sifat-sifatnya dapat dikelompokkan kedalam 2 kelompok, yang disebut kelompok yin dan kelompok yang.
Semua benda yang yang sifatnya mendekati api dikelompokkan kedalam kelompok yang dan semua benda yang sifatnya mendekati air dikelompokkan kedalam kelompok yin. Api dan air digunakan sebagai patokan dalam keadaan wajar, dan dari sifat api dan air dirumuskan sifat-sifat penyakit dan cara penyembuhannya.

Seseorang dikatakan sehat bila hubungan dan perimbangan yang dan yin relatif seimbang. Tidak ada keseimbangan mutlak dan statis, hubungan antara yang dan yin selalu dinamis. Sakit adalah suatu gejala adanya ketidakseimbangan antara unsur-unsur yang-yin, baik antara manusia (yin) dengan alam semesta (yang), maupun antara manusia satu dengan lainnya, atau antara unsur-unsur kehidupan di dalam tubuh sendiri. Istilah dalam kedokteran tradisional cina, akupresur digunakan agar tubuh bekerja lebih efisien. Dari model medis, teknik akupressur dapat menyebabkan pelepasan endorphine, memblok reseptor nyeri ke otak, menyebabkan dilatasi serviks dan meningkatkan efektifitas kontraksi uterus.

Dalam kedokteran tradisional cina, meridian merupakan saluran yang membawa chi (energi) pada tubuh. Meridian merupakan bagian dari sistem syaraf, pembuluh darah, dan saluran limpa. Meridian terdiri dari 600 titik. Titik meridian tersebut menyeimbangkan energi tubuh yang menyebabkan tubuh berfungsi.
Berapa sering tindakan akupresur dilakukan, tergantung pada kebutuhan individu. Metode akupresur merupakan tindakan yang mudah dilakukan,memberi kekuatan pada wanita saat melahirkan dan mendorong keterlibatan pasangan lebih dekat dalam proses persalinan dan pendidikan antenatal.

Lokasi Titik Akupresur yang berguna saat persalinan antara lain :
Titik Cien Cing
Titik ini dapat diketahui dengan cara menarik garis khayal antara C7 menuju prosessus acromion, titik cien cing terletak pada pertengahan garis tersebut. Akupresuris dapat menemukan titik ini pada tubuh sendiri dengan mengangkat tangan diagonal melewati dada dan palpasi sendiri dengan menggunakan jari telunjuk sepanjang garis khayal tersebut.
Titik ini berguna pada fase pertama dan kedua persalinan untuk menstimulasi kontraksi uterus. Titik ini merupakan titik terbaik digunakan saat menyusui, membuat rileks otot pundak dan meningkatkan suplay ASI.
Teknik akupresur :
Lakukan penekanan kebawah pada titik cien cing tersebut menggunakan ibu jari, atau siku. Ketika menggunakan ibu jari, berikan tekanan yang berasal dari lengan bukan tekanan yang berasal dari sendi ibu jari. Pada titik ini sebaiknya dilakukan pada kedua bahunya, namun dapat juga dilakukan sendiri pada satu bahu.
Tekanan dapat dilakukan pada setiap permulaan kontraksi atau lakukan penekanan lembut secara terus-menerus untuk mengintensifkan kontraksi.

Titik Bl 32 (Pang Kuang Su)
Lokasi titik ini kira-kira sepanjang jari telunjuk wanita diatas lipat pantat selebar ibu jari disisi tulang belakang.
Saat persalinan mulai, awali teknik akupresur dengan melakukan penekanan pada titik ini dengan menggerakkan jari menuruni tulang belakang (kira-kira selebar ibu jari) sejalan dengan kemajuan persalinan.
Teknik akupresur :
- Tempatkan jari pada titik akupresur dan lakukan tekanan yang lembut. Tekanan dapat ditingkatkan dengan melakukan penekanan kearah belakang pada awal kontraksi.
- Titik ini lebih banyak digunakan karena meningbulkan efek ’anestesi’ pada kontraksi yang kuat, terlihat jelas efek ini saat penekanan dihentikan.
- Penekanan pada titik ini akan menimbulkan rasa hangat, geli,dan agak sakit. Jika terasa sangat sakit, lakukan penekanan pada sekitar tulang.
- Titik ini sering digunakan pada wanita dengan posisi menunduk atau berlutut pada lantai, meja, tempat tidur dll. Teknik ini dapat juga efektif digunakan dalam air, namun kurang fleksibel pada sebagian orang.
- Penekanan kuat pada titik BL32 dapat dilakukan pada wanita bersalin yang selalu ingin mengedan sedangkan serviks belum cukup berdilatasi

Titik pantat
Titik ini berada pada garis horisontal dari puncak lipatan pantat. Jika melakukan tekanan pada sepanjang garis ini akan terasa lembut kira-kira dua pertiga antara lipat pantat dann tulang pinggul.

Teknik akupresur :
Tempatkan tangan pada pinggul pasien dan lakukan dorongan kedalam titik ini dengan menggunakan ibu jari dan bantu ibu untuk bergerak saat kontraksi.
Dua samapai 3 hari sebelum tanggal persalinan, BL 32 dan titik pantat dapat digunakan bersamaan dengan masage pada sakral, lakukan penekanan kebawah dan mengelilingi pantat. Tujuannya adalah memberikan energi pada serviks agar persalinan berjalan secara optimal.

Titik pada Tangan
Titik ini terletak sepanjang lipatan tangan ketika jari-jari menyatu pada telapak tangan. Titik ini membantu pelepasan endorphin ke dalam tubuh.

Teknik akupresur :
Pegang sisir kecil dengan kencang. Pasien dapat menggenggam sisir tersebut saat kontraksi dan anjurkan pada pasien untuk melakukan tindakan ini bila terasa bermanfaat.Titik ini sangat membantu untuk menurunkan nyeri saat kontraksi

Titik K1 . Titik ini terletak pada 1/3 bagian atas telapak kaki, ketika telapak kaki fleksi (menarik jari kaki kedepan kearah telapak kaki)

Teknik akupresur :
Lakukan penekanan yang kuat kedalam dan kedepan kearah jempol kaki. Titik ini mempunyai efek relaksasi dan dapat digunakan kapan saja saat persalinan dan sangat efektif dilakukan selama fase kedua persalinan. Penekanan pada titik ini juga dapat berguna saat pasien panik (misal mempunyai pengalaman yang tidak menyenangkan pada persalinan sebelumnya). Titik ini berguna untuk membantu perineum relaksasi selama fase kedua persalinan.

Titik Co4 (He Kuk)
Titik ini terletak antara tulang metakarpal pertama dan kedua (antara ibu jari dan jari telunjuk) pada bagian distal lipatan pada kedua tangan.

Teknik akupresur :
Berikan penekanan pada titik ini dengan menggunakan ibu jari. Penekanan pada titik ini berguna untuk mengintensifkan kontraksi, saat kontraksi ireguler.
Titik Co4 dapat digunakan selama fase keduapersalinan. Hal ini bertujuan agar tubuh berusaha menggerakkan bayi turunmelewati jalan lahir. Penekanan pada titik ini sangat berguna terutama pada saat ibu kelelahan dan mengedan tidak efektif.

Titik akupresur jika persalinan tidak mengalami kemajuan
Titik Sp6 (San Yin Ciao) Tititk ini penting untuk membantu dilatasi serviks dan dapat digunakan ketika serviks tidak efektif berdilatasi selama persalinan.
Titik ini terletak empat jari diatas mata kaki dalam.

Teknik Akupresur :
- Lakukan tekanan langsung pada titik ini dengan telunjuk atauibu jari.
- Gunakan titik ini pada satu kaki kira-kira satu menit (hitung perlahan sampai 60!) kemudian gunakan titik ini pada kaki yang lain setelah 20-30 menit.
- Setelah dilakukan penekanan pada titik ini, beberapa wanita akan merasakan serviks meregang dan kontraksi semakin kuat.
- Teknik ini sebaiknya tidak digunakan saat persalinan berjalan normal, persalinan bukan berapa jam dapat melahirkan, namun bagaimana menikmati proses melahirkan.
- Ketika ketuban telah pecah dan persalinan tidak mengalami kemajuan dapat dilakukan penekanan pada BL32 dan Sp 6 untuk membantu persalinan

Titik P6
Titik ini terletak 3 jari diatas pergelangan tangan segaris dengan jari tengah.
Teknik akupresur :
Titik ini dapat digunakan pada mual ringan sampai muntah. Lakukan penekanan pada titik ini dan pertahankan sampai terasa efektif, biasanya selama 5 menit. Penekanan ini dapat dilakukan pada satu pergelangan tangan atau keduanya.

C. KESIMPULAN
Teknik akupresur merupakan salah satu teknik nonfarmakologis yang sangat efektif dalam manajemen nyeri persalinan. Teknik akupresur dapat menyebabkan pelepasan endorphine, memblok reseptor nyeri ke otak, menyebabkan dilatasi serviks dan meningkatkan efektifitas kontraksi uterus. Tindakan akupresur merupakan tindakan noninfasif yang tidak mempunyai efek merugikan bagi pasien sehingga dan dapat dilakukan oleh perawat atau keluarga pasien. Metode akupresur merupakan tindakan yang mudah dilakukan, memberi kekuatan pada wanita saat melahirkan dan mendorong keterlibatan pasangan lebih dekat dalam proses persalinan dan pendidikan antenatal.

D. DAFTAR PUSTAKA
Betts. Debra Acupuncture technique foruse duringchildbirth and pregnancy. http://www.childbirthsolutions.com/articles/birth/acupressure/index.php. Diambil pada tanggal 20 April 2007
Sukanta Putu Oka. (2003). Akupresur dan minuman untuk mengatasi gangguan kesehatan reproduksi. PT Elex Media Komputindo,Jakarta
Sylvia T. Brown, Carol Douglas, LeeAnn Plaster(2001). Womenn’s Evaluationof Intrapartum Nonpharmacological pain relief methods used during labor. http://www.pubmedcentral.nih.gov/articlerender.fcgi. diambil pada tanggal 20 April 2007

Category: KEPERAWATAN MATERNITAS  Comments off

I have two full time jobs – I’m a customer service center manager and a mom of two young kids. I see myself as a happy person and a hard worker. But last month, the commute to work, my job, the chores around the house, and trying to spend enough time with my kids was really stressing me out. I have to get up really early in the morning to get the kids ready for school, then it takes me so long to get to work that I’m in a bad mood by the time I get there. My office is short-staffed and we had a lot of deadlines to meet so I was working overtime. My home life suffered?traffic going home doesn’t help my mood, and when I got there, I was just so tired I didn’t want to do anything! But I was faced with making dinner and doing laundry. My kids need my attention too!

I wanted to handle my stress before it got the best of me. I talked with my boss about working later hours so I don’t run into so much traffic and am in a better mood when I get there and get home. I asked my husband to pick up the kids from school, and he has offered to help more with dinner and the laundry. When he cooks, I go for a bike ride with my kids. I also started setting five minutes aside in the morning and in the afternoon at work for me to relax and take a deep breath. These small changes have made a big difference in my lif
What are some of the most common causes of stress?

Stress can arise for a variety of reasons. Stress can be brought about by a traumatic accident, death, or emergency situation. Stress can also be a side effect of a serious illness or disease.

There is also stress associated with daily life, the workplace, and family responsibilities. It’s hard to stay calm and relaxed in our hectic lives. As women, we have many roles: spouse, mother, caregiver, friend, and/or worker. With all we have going on in our lives, it seems almost impossible to find ways to de-stress. But it’s important to find those ways. Your health depends on it.

What are some early signs of stress?

Stress can take on many different forms, and can contribute to symptoms of illness. Common symptoms include headache, sleep disorders, difficulty concentrating, short-temper, upset stomach, job dissatisfaction, low morale, depression, and anxiety.

How do women tend to react to stress?

We all deal with stressful things like traffic, arguments with spouses, and job problems. Some researchers think that women handle stress in a unique way: we tend and befriend.

* Tend : women protect and care for their children
* Befriend : women seek out and receive social support

During stress, women tend to care for their children and find support from their female friends. Women’s bodies make chemicals that are believed to promote these responses. One of these chemicals is oxytocin (ahk-see-toe-sin), which has a calming effect during stress. This is the same chemical released during childbirth and found at higher levels in breastfeeding mothers, who are believed to be calmer and more social than women who don’t breastfeed. Women also have the hormone estrogen, which boosts the effects of oxytocin. Men, however, have high levels of testosterone during stress, which blocks the calming effects of oxytocin and causes hostility, withdrawal, and anger.

How does stress affectimy body and my health?

Everyone has stress. We have short-term stress, like getting lost while driving or missing the bus. Even everyday events, such as planning a meal or making time for errands, can be stressful. This kind of stress can make us feel worried or anxious.

Other times, we face long-term stress, such as racial discrimination, a life-threatening illness, or divorce. These stressful events also affect your health on many levels. Long-term stress is real and can increase your risk for some health problems, like depression.

Both short and long-term stress can have effects on your body. Research is starting to show the serious effects of stress on our bodies. Stress triggers changes in our bodies and makes us more likely to get sick. It can also make problems we already have worse. It can play a part in these problems:

* trouble sleeping
* headaches
* constipation
* diarrhea
* irritability
* lack of energy
* lack of concentration
* eating too much or not at all
* anger
* sadness

* higher risk of asthma and arthritis flare-ups

* tension
* stomach cramping
* stomach bloating
* skin problems, like hives

* depression
* anxiety
* weight gain or loss
* heart problems
* high blood pressure

* irritable bowel syndrome
* diabetes
* neck and/or back pain
* less sexual desire
* harder to get pregnant

What are some of the most stressful life events?

Any change in our lives can be stressful?even some of the happiest ones like having a baby or taking a new job. Here are some of life’s most stressful events.

* death of a spouse
* divorce
* marital separation
* spending time in jail
* death of a close family member
* personal illness or injury
* marriage
* pregnancy
* retirement

From the Holmes and Rahe Scale of Life Events (1967)

What is post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder (PTSD) can be a debilitating condition that can occur after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that can trigger PTSD include violent personal assaults such as rape or mugging, natural or human-caused disasters, accidents, or military combat.

Many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects that remind them of the trauma. Anniversaries of the event can also trigger symptoms. People with PTSD also can have emotional numbness, sleep disturbances, depression, anxiety, irritability, or outbursts of anger. Feelings of intense guilt (called survivor guilt) are also common, particularly if others did not survive the traumatic event.

Most people who are exposed to a traumatic, stressful event have some symptoms of PTSD in the days and weeks following the event, but the symptoms generally disappear. But about 8% of men and 20% of women go on to develop PTSD, and roughly 30% of these people develop a chronic, or long-lasting, form that persists throughout their lives.

How can I help handle my stress?

Don’t let stress make you sick. As women, we tend to carry a higher burden of stress than we should. Often we aren’t even aware of our stress levels. Listen to your body, so that you know when stress is affecting your health. Here are ways to help you handle your stress.

* Relax. It’s important to unwind. Each person has her own way to relax. Some ways include deep breathing, yoga, meditation, and massage therapy. If you can’t do these things, take a few minutes to sit, listen to soothing music, or read a book.
* Make time for yourself. It’s important to care for yourself. Think of this as an order from your doctor, so you don’t feel guilty! No matter how busy you are, you can try to set aside at least 15 minutes each day in your schedule to do something for yourself, like taking a bubble bath, going for a walk, or calling a friend.
* Sleep. Sleeping is a great way to help both your body and mind. Your stress could get worse if you don’t get enough sleep. You also can’t fight off sickness as well when you sleep poorly. With enough sleep, you can tackle your problems better and lower your risk for illness. Try to get seven to nine hours of sleep every night.
* Eat right. Try to fuel up with fruits, vegetables, and proteins. Good sources of protein can be peanut butter, chicken, or tuna salad. Eat whole-grains, such as wheat breads and wheat crackers. Don’t be fooled by the jolt you get from caffeine or sugar. Your energy will wear off.
* Get moving. Believe it or not, getting physical activity not only helps relieve your tense muscles, but helps your mood too! Your body makes certain chemicals, called endorphins, before and after you work out. They relieve stress and improve your mood.
* Talk to friends. Talk to your friends to help you work through your stress. Friends are good listeners. Finding someone who will let you talk freely about your problems and feelings without judging you does a world of good. It also helps to hear a different point of view. Friends will remind you that you’re not alone.
* Get help from a professional if you need it. Talk to a therapist.A therapist can help you work through stress and find better ways to deal with problems. For more serious stress related disorders, like PTSD, therapy can be helpful. There also are medications that can help ease symptoms of depression and anxiety and help promote sleep.
* Compromise. Sometimes, it’s not always worth the stress to argue. Give in once in awhile.
* Write down your thoughts. Have you ever typed an email to a friend about your lousy day and felt better afterward? Why not grab a pen and paper and write down what’s going on in your life! Keeping a journal can be a great way to get things off your chest and work through issues. Later, you can go back and read through your journal and see how you’ve made progress!
* Help others. Helping someone else can help you. Help your neighbor, or volunteer in your community.
* Get a hobby. Find something you enjoy. Make sure to give yourself time to explore your interests.
* Set limits. When it comes to things like work and family, figure out what you can really do. There are only so many hours in the day. Set limits with yourself and others. Don’t be afraid to say NO to requests for your time and energy.
* Plan your time. Think ahead about how you’re going to spend your time. Write a to-do list. Figure out what’s most important to do.
* Don’t deal with stress in unhealthy ways. This includes drinking too much alcohol, using drugs, smoking, or overeating.

I heard deep breathing could help my stress. How do I do it?

Deep breathing is a good way to relax. Try it a couple of times every day. Here’s how to do it.

1. Lie down or sit in a chair.
2. Rest your hands on your stomach.
3. Slowly count to four and inhale through your nose. Feel your stomach rise. Hold it for a second.
4. Slowly count to four while you exhale through your mouth. To control how fast you exhale, purse your lips like you’re going to whistle. Your stomach will slowly fall.
5. Repeat five to 10 times.

Does stress cause ulcers?

Doctors used to think that ulcers were caused by stress and spicy foods. Now, we know that stress doesn’t cause ulcers?it just irritates them. Ulcers are actually caused by a bacterium (germ) called H. pylori. Researchers don’t yet know for sure how people get it. They think people might get it through food or water. It’s treated with a combination of antibiotics and other drugs.

Category: psichology  Comments off

The prostate is a gland that is involved in the male reproductive system. When cells of the prostate begin to grow too rapidly and become out of control, a disease develops that is called prostate cancer. In addition to forming masses in the prostate, prostate cancer has the ability to metastasize and spread to other parts of the body, including the bones and lymph nodes. Common symptoms of prostate cancer include difficulty urinating, pain, problems during sex and erectile dysfunction.

Rates of prostate cancer vary around the world. However, prostate cancer is most common in the United States. It generally occurs in men over the age of 50, and is one of the most common forms of cancer for males. In many cases, however, it can cause no symptoms and will also not negatively impact a man’s health. rostate cancer is usually detected by a blood test called a PSA screen, which looks for a specific compound called Prostate Specific Antigen. Then, the prostate is biopsied and the tissue sample is examined under a microscope.

In general, if prostate cancer is causing discomfort or is considered to be a risk for a patient’s health, there are two main treatment options. The first is surgery. A surgeon will take out the tumor and the surrounding tissue and the edges of the removed tissue will be examined to make sure that the cancer has not spread. The other option is radiation therapy, in which carefully controlled bursts of radiation will be directed at the prostate. Radiation kills cells that are dividing and, since cancer cells grow and divide very rapidly, the cancerous cells will be the most affected

Category: askep cancer prostat  Comments off