nursing

1. Asuhan
keperawatan pada
pasien dengan
encepalitis
Ns. Dyah Untari M.Kep Sp Kep MB

2. Encepalitis adalah
Ensefalitis adalah peradangan pada parenkim otak
biasanya disebabkan oleh bakteri atau virus, dan sering
dikaitkan dengan meningitis. Virus sangat bervariasi
dalam potensinya untuk menghasilkan infeksi sistem saraf
pusat (SSP): misalnya, virus rabies

3. • virus herpes simpleks 1 (HSV-1),
• varicella zostervirus (VZV),
• enterovirus, virus Epstein-Barr (EBV),
• human herpesvirus 6 (HHV-6),
• virus campak
• rabies,
• West Nile Virus (WNV),
• Human immunodeficiency virus (HIV)
• Encepalitis karena parasite ( malaria).
Etiologi encephalitis

4. Angka kejadian encephalitis
Encefalitis morbiditas dan mortalitas yang tinggi serta biaya
ekonomi yang cukup besar.
Insiden bervariasi antar studi tetapi umumnya antara 3,5 dan
7,4 per 100.000 pasien-tahun.
Kasus encephalitis Anak lebih tinggi dari orang dewasa
40%
30%
20%
10%
40%

5. Pemeriksaan Penunjang
CT scan otak seringkali didapat hasil normal, tetapi
bisa pula didapat hasil edema diffuse, dan pada
kasus khusus seperti Ensefalitis herpes simplex, ada
kerusakan selektif pada lobus inferomedial temporal
dan lobus frontal (Anania, 2002)..
CT Scan
EEG sering menunjukkan aktifitas listrik yang
merendah sesuai dengan kesadaran yang menurun.
Adanya kejang, koma, tumor, infeksi sistem saraf,
bekuan darah, abses, jaringan parut otak, dapat
menyebabkan aktivitas listrik berbeda dari pola
normal irama dan kecepatan.(Smeltzer, 2002)
EEG
uji fiksasi komplemen, uji inhibisi
hemaglutinasi dan uji neutralisasi.
Pada pemeriksaan serologis dapat
diketahui reaksi antibodi tubuh.
IgM dapat dijumpai pada awal
gejala penyakit timbul.
Pemeriksaan serologis
terjadi peningkatan angka leukosit.
.
Pemeriksaan darah
viremia berlangsung hanya sebentar saja sehingga sukar untuk
mendapatkan hasil yang positif. Biakan dari likuor serebrospinalis atau
jaringan otak (hasil nekropsi), akan didapat gambaran jenis kuman dan
sensitivitas terhadap antibiotika. Biakan dari feses, untuk jenis enterovirus
sering didapat hasil yang positif.
Biakan darah
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6. Asuhan Keperawatan

7. Pengkajian Keperawatan
a. Identitas : Ensefalitis dapat terjadi pada semua
kelompok umur.
b. Keluhan Utama, berupa panas badan meningkat,
kejang, dan kesadaran menurun.
c. Riwayat Penyakit Sekarang : Mula-mula anak rewel,
gelisah, muntah-muntah, panas badan meningkat
kurang lebih 1-4 hari, sakit kepala.
d. Riwayat Penyakit Dahulu : Klien sebelumnya
menderita batuk, pilek kurang lebih 1-4 hari, pernah
menderita penyakit Herpes, penyakit infeksi pada
hidung, telinga dan tenggorokan.
e. Riwayat Penyakit Keluarga : Keluarga ada yang
menderita penyakit yang disebabkan oleh virus contoh
: Herpes dan lain-lain. Bakteri contoh : Staphylococcus
Aureus,Streptococcus, E, Coli, dan lain-lain.
f. Imunisasi : Kapan terakhir diberi imunisasi DTP,
karena ensefalitis dapat terjadi pada post imunisasi
pertusis

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