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"Adanya kehilangan cairan akibat diare berdampak terhadap timbulnya masalah gangguan keseimbangan cairan dan elektrolit Karya ilmiah akhir ini bertujuan memberikan gambaran aplikasi teori konservasi Levine pada anak diare dengan gangguan masalah keseimbangan cairan dan elektrolit dan pencapaian kompetensi perawat spesialis keperawatan anak Kelima kasus kelolaan memperlihatkan hidrasi tidak adekuat Pada trophicognosis ketidakseimbangan volume cairan melalui intervensi rehidrasi adekuat berfokus memaksimalkan konservasi Respon organismik adanya hidrasi adekuat dan permasalahan pada kelima kasus dapat teratasi dalam kurun waktu perawatan yang bervariasi

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Presence of fluid loss due to diarrhea incidence problem affecting fluid and electrolyte balance disorders This final scientific work aims to provide an overview of conservation theory application Levine diarrhea in children with disorders of fluid and electrolyte balance problems and achieving competence of nurse specialist nursing child The fifth case management showed inadequate hydration At trophicognosis fluid volume imbalance through focused interventions to maximize the conservation of adequate rehydration The organismic response adequate hydration and problems in the five cases can be resolved within a period of treatment varies "

"ABSTRAK Dehidrasi dapat menyebabkan terjadinya hipovolemia, kegagalan organ, danbahkan berakhir dengan kematian. Asuhan keperawatan yang berkualitas sangatdiperlukan dalam mengatasi masalah gangguan cairan pada anak. Karya ilmiahakhir ini bertujuan untuk memberikan gambaran aplikasi Model KonservasiMyra E. Levine dalam memberikan asuhan keperawatan pada anak dengan kankeryang mengalami ketidakseimbangan cairan. Intervensi berdasarkan modelkonservasi Levine yaitu mengkaji tanda-tanda dehidrasi, memantau adanyamuntah, diare dan demam, mengukur tanda-tanda vital, mengukur intake outputcairan dan melakukan analisis terhadap balance cairan. Evaluasi setelahdilakukan intervensi keperawatan pada kasus 1, 2, dan 3 masalah risikokekurangan volume cairan tubuh tidak terjadi, sedangkan pada kasus 4 sampaidengan 5, masalah ketidakseimbangan cairan teratasi. Rekomendasi karya ilmiahini adalah dalam memberikan asuhan keperawatan pada anak dengan kasushemato-onkologi yang mengalami ketidakseimbangan cairan kepada pasien dapatmenerapkan teori keperawatan model konservasi Myra E. Levine.ABSTRACT Dehydration can lead to hypovolemia, organ failure, and even death. Qualitynursing care is of high importance in addressing the problem of fluid imbalancein children. This paper aimed to describe the application of Levine?sConservation Model in providing nursing care to children with cancer whoexperience fluid imbalance. Based on this model, the interventions includereviewing signs of dehydration, monitoring vomiting, diarrhea, and fever,measuring vital signs, measuring the fluid intake and output and analyzing thefluid balance. After the nursing intervention, the problem of risk of body fluidvolume deficiency did not occur in cases number 1, 2, and 3; while in the casesnumber 4 and 5 in which fluid imbalance already happened, this imbalanceproblem was resolved. It can be concluded that Levine?s model is an effectiveapproach to manage the fluid imbalance problem in children with hematooncologycases.;Dehydration can lead to hypovolemia, organ failure, and even death. Qualitynursing care is of high importance in addressing the problem of fluid imbalancein children. This paper aimed to describe the application of Levine?sConservation Model in providing nursing care to children with cancer whoexperience fluid imbalance. Based on this model, the interventions includereviewing signs of dehydration, monitoring vomiting, diarrhea, and fever,measuring vital signs, measuring the fluid intake and output and analyzing thefluid balance. After the nursing intervention, the problem of risk of body fluidvolume deficiency did not occur in cases number 1, 2, and 3; while in the casesnumber 4 and 5 in which fluid imbalance already happened, this imbalanceproblem was resolved. It can be concluded that Levine?s model is an effectiveapproach to manage the fluid imbalance problem in children with hematooncologycases.;Dehydration can lead to hypovolemia, organ failure, and even death. Qualitynursing care is of high importance in addressing the problem of fluid imbalancein children. This paper aimed to describe the application of Levine?sConservation Model in providing nursing care to children with cancer whoexperience fluid imbalance. Based on this model, the interventions includereviewing signs of dehydration, monitoring vomiting, diarrhea, and fever,measuring vital signs, measuring the fluid intake and output and analyzing thefluid balance. After the nursing intervention, the problem of risk of body fluidvolume deficiency did not occur in cases number 1, 2, and 3; while in the casesnumber 4 and 5 in which fluid imbalance already happened, this imbalanceproblem was resolved. It can be concluded that Levine?s model is an effectiveapproach to manage the fluid imbalance problem in children with hematooncologycases.;Dehydration can lead to hypovolemia, organ failure, and even death. Qualitynursing care is of high importance in addressing the problem of fluid imbalancein children. This paper aimed to describe the application of Levine?sConservation Model in providing nursing care to children with cancer whoexperience fluid imbalance. Based on this model, the interventions includereviewing signs of dehydration, monitoring vomiting, diarrhea, and fever,measuring vital signs, measuring the fluid intake and output and analyzing thefluid balance. After the nursing intervention, the problem of risk of body fluidvolume deficiency did not occur in cases number 1, 2, and 3; while in the casesnumber 4 and 5 in which fluid imbalance already happened, this imbalanceproblem was resolved. It can be concluded that Levine?s model is an effectiveapproach to manage the fluid imbalance problem in children with hematooncologycases.;Dehydration can lead to hypovolemia, organ failure, and even death. Qualitynursing care is of high importance in addressing the problem of fluid imbalancein children. This paper aimed to describe the application of Levine?sConservation Model in providing nursing care to children with cancer whoexperience fluid imbalance. Based on this model, the interventions includereviewing signs of dehydration, monitoring vomiting, diarrhea, and fever,measuring vital signs, measuring the fluid intake and output and analyzing thefluid balance. After the nursing intervention, the problem of risk of body fluidvolume deficiency did not occur in cases number 1, 2, and 3; while in the casesnumber 4 and 5 in which fluid imbalance already happened, this imbalanceproblem was resolved. It can be concluded that Levine?s model is an effectiveapproach to manage the fluid imbalance problem in children with hematooncologycases."

"Penulisan karya ilmiah akhir ini bertujuan untuk menggambarkan penerapan teoriModel Konservasi pada bayi dengan gangguan rasa nyaman nyeri. Nyeri padabayi perlu mendapat perhatian penting dari perawat karena dapat mempengaruhipertumbuhan dan perkembangan di masa yang akan datang. Penatalaksanaannyeri dilakukan secara farmakologis dan non farmakologis. Penatalaksanaan nyerinon farmakologis dapat dilakukan dengan cara pengaturan posisi, facilitatedtucking, pacifier dan sensasi multisensory. Penatalaksanaan nyeri perlu dilakukanoleh seorang perawat yang kompeten, yang dilakukan melalui berbagai peran,yaitu sebagai pemberi asuhan, advokat, pendidik, penelitidan pemimpin.

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This paper aims to describe the application on Levine Conservation Model in the

care of infant experiencing altered comfort: pain. Pain should become a nursing

concern since it will have impacts on baby’s growth and development in the

future. Pain can be managed by pharmacological and non-pharmacological

approaches.

Non-pharmacological management can be provided by positioning the baby,

facilitated tucking position, pacifier and multisensory sensations. Nonpharmacological

management can be provided by positioning the baby,

facilitating tucking, providing non-nutritive sucking, and

Nurses implement pain management throughout their roles as care giver,

advocator, educator, researcher, and leader.

Key word : Conservation theory, pain, non pharm"

"Pengobatan osteosarkoma terdiri dari operasi, kemoterapi dan radioterapi. Osteosarkoma memiliki prognosis yang buruk jika tidak mendapatkan kemoterapi yang efektif. Efek samping yang sering dialami anak dengan pengobatan kemoterapi adalah mual muntah, yang berdampak pada kelangsungan hidup anak. Pemberian obat kemoterapi tidak hanya berdampak kepada pasien, tapi juga berdampak terhadap orang-orang yang kontak dengan obat tersebut ataupun kontak dengan cairan tubuh dan kotoran pasien (urine dan feses) yang mendapatkan pengobatan kemoterapi. Teori konservasi energi Myra Estrin Levine diharapkan dapat membuat tata laksana dilakukan secara menyeluruh, pasien terhadap efek samping obat kemoterapi dan orang-orang yang kontak dengan obat tersebut terhadap risiko paparan obat kemoterapi itu sendiri. Tujuan penulisan karya ilmiah akhir spesialis ini adalah memberikan gambaran aplikasi teori konservasi energi Myra Estrin Levine dalam asuhan keperawatan pada pasien anak dengan osteosarkoma yang mengalami masalah mual muntah di ruang kemoterapi. Berdasarkan hasil evaluasi pada lima anak dengan masalah mual muntah saat menjalani kemoterapi, didapatkan hasil bahwa terdapat penurunan keluhan mual, porsi makanan yang dihabiskan mengalami peningkatan, napsu makan mulai membaik, pemberian terapi antiemetik diberikan sesuai program medis dan keluarga kooperatif mengikuti hipotesis. Kepatuhan penggunaan APD dalam pemberian obat kemoterapi berupa cap, masker, dan sarung tangan tanpa diingatkan sebesar 100% dan kepatuhan penggunaan APD berupa goggle, dan gown sebesar 73,3%.  Kesimpulan aplikasi teori konservasi energi Myra Estrin Levine dapat diterapkan pada anak dengan masalah mual muntah di ruang kemoterapi dan penerapan quality improvement project program peningkatan kepatuhan penggunaan alat pelindung diri (APD) terbukti efektif dalam pemberian obat kemoterapi.

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Treatment of osteosarcoma consists of surgery, chemotherapy and radiotherapy. Osteosarcoma has a poor prognosis if it does not receive effective chemotherapy. A common side effect of chemotherapy treatment is nausea and vomiting, which impacts the child's survival. The administration of chemotherapy drugs not only affects the patient, but also affects people who come into contact with the drugs or contact with the body fluids and faeces of patients (urine and faeces) who receive chemotherapy treatment. Myra Estrin Levine's energy conservation theory is expected to make the management carried out as a whole, the patient against the side effects of chemotherapy drugs and people who come into contact with the drug against the risk of exposure to chemotherapy drugs themselves. The purpose of writing this specialist final scientific paper is to provide an overview of the application of Myra Estrin Levine's energy conservation theory in nursing care in pediatric patients with osteosarcoma who experience nausea and vomiting problems in the chemotherapy room. Based on the results of the evaluation of five children with the problem of nausea and vomiting while undergoing chemotherapy, it was found that there was a decrease in complaints of nausea, the portion of food spent increased, the appetite began to improve, the administration of antiemetic therapy was given according to the medical programme and the family cooperatively followed the hypothesis. Compliance with the use of PPE in administering chemotherapy drugs in the form of caps, masks, and gloves without being reminded is 100% and compliance with the use of PPE in the form of goggles and gowns is 73.3%.  In conclusion, the application of Myra Estrin Levine's energy conservation theory can be applied to children with nausea and vomiting problems in the chemotherapy room and the application of the quality improvement project programme to increase compliance with the use of personal protective equipment (PPE) has proven effective in administering chemotherapy drugs."

"Gangguan oksigenasi merupakan masalah yang sering dialami oleh pasien yang dirawat di ruang perawatan intensif anak. Oksigen merupakan kemponen yang penting dalam pembentukan energi sehingga gangguan oksigenasi dapat memengaruhi keseimbangan energi. Teori Konservasi Levine bertujuan untuk mempertahankan keutuhan pasien melalui empat prinsip konservasi yaitu konservasi energi, konservasi integritas strukrutal, konservasi integritas personal dan konservasi integritas sosial sehingga dapat diaplikasikan pada anak dengan gangguan oksigenasi. Salah satu intervensi keperawatan yang sesuai dengan prinsip konservasi energi pada pasien dengan masalah oksigenasi adalah pengaturan posisi lateral kanan. Tujuan dari karya ilmiah ini adalah memberikan gambaran mengenai aplikasi teori Konservasi Levine dalam pemenuhan kebutuhan oksigenasi dan pengaruh pengaturan posisi lateral kanan pada anak yang dirawat di ruang perawatan intensif. Asuhan keperawatan dengan pendekatan teori Konservasi Levine diberikan kepada lima anak yang terpasang ventilator. Proses keperawatan mulai dari pengkajian sampai evaluasi dilakukan berdasarkan empat prinsip konservasi. Evaluasi keperawatan menunjukkan adanya perbaikan kondisi pada beberapa pasien. Demikian halnya dengan pengaturan posisi lateral kanan dengan kemiringan 30° terbukti efektif meningkatkan saturasi oksigen pada anak yang terpasang ventilasi mekanik. Penulis merekomendasikan penggunaan teori Konservasi Levine dalam memberikan asuhan keperawatan kepada anak dengan gangguan oksigenasi di ruang perawatan intensif. Selain itu penulis merekomendasikan pengaturan posisi lateral kanan dengan kemiringan 30° untuk dapat diaplikasikan di ruang perawatan intensif anak serta dilakukan uji klinik lebih lanjut dengan sampel yang lebih besar sehingga dapat dijadikan dasar penyusunan standar operasional prosedur.

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Oxygenation impairment is one of the problems that is often experienced by patients treated in pediatric intensive care units. Oxygen is an important component in energy formation.  Oxygenation impairment can affect energy balance. Levine's Conservation theory focuses on maintaining patient wholeness through four conservation principles, namely conservation of energy, conservation of structural integrity, conservation of personal integrity, and conservation of social integrity so that it can be applied to children with oxygenation impairment. One of the nursing interventions that relate to the conservation of energy in patients with oxygenation impairment is the positioning with the right lateral position. The purpose of this scientific paper is to provide an overview of the application of Levine's Conservation theory in meeting oxygenation needs and the effect of right lateral position in children treated in intensive care units. Nursing care with the application Levine Conservation theory was given to five children who were on ventilators. The nursing process from assessment to evaluation was carried out based on four conservation principles. Nursing evaluation showed an improvement in the condition of several patients. Likewise, the right lateral position setting with a 30° tilt has shown to be effective in increasing oxygen saturation in children who are on mechanical ventilation. The author recommends the use of Levine's Conservation theory in providing nursing care to children with impaired oxygenation in intensive care units. In addition, the author recommends setting the right lateral position with a 30° tilt to be applied in the pediatric intensive care room and conducting further clinical trials with larger samples so that it can be used as a basis for compiling standard operating procedures."