
Asuhan Kebidanan Komprehensif Pada Ny. N Di Wilayah Puskesmas Pantai Amal
Pengarang : Shinta Pramitha - Personal Name;
Perpustakaan UBT : Universitas Borneo Tarakan., 2024XML Detail Export Citation
Abstract
Pelayanan Kebidanan Komprehensif merupakan pelayanan asuhan kebidanan yang dilaksanakan secara menyeluruh mulai dari kehamilan, persalinan, nifas hingga bayi baru lahir. Tujuan dari pelayanan kebidanan ini adalah untuk dapat mendeteksi apa yang terjadi pada seorang wanita mulai dari masa kehamilan, persalinan, lahirnya bayi hingga masa nifas serta melatih cara melakukan pengkajian, memberikan diagnosis yang akurat, mengantisipasi masalah yang mungkin timbul, menentukan tindakan segera, merencanakan dan bertindak sesuai kebutuhan ibu serta mampu mengevaluasi tindakan yang dilakukan. Asuhan kebidanan komprehensif atau Continuity Of Care yang dilakukan penulis dimulai pada kehamilan trimester III, persalinan, nifas, dan bayi baru lahir secara berkelanjutan dengan menggunakan standar asuhan kebidanan. Asuhan diberikan mulai dari tanggal 18 Maret 2024 – 20 Maret 2024. Kunjungan asuhan kebidanan dilakukan di Puskesmas Pantai Amal. Kunjungan hamil dilakukan sebanyak satu kali, kunjungan bersalin satu kali, kunjungan nifas dan bayi baru lahir satu kali. Sehingga penulis melakukan kunjungan komprehensif sebanyak empat kali. Asuhan kebidanan komprehensif pertama kali dilakukan pada saat kunjungan kehamilan di trimester III pada tanggal 18 Maret 2024 dengan usia kehamilan ibu 39 minggu 2 hari, didapatkan setelah pengkajian dilakukan dari kunjungan masa kehamilan dalam kondisi normal dan tidak ditemukan adanya komplikasi apapun. Asuhan persalinan diberikan pada tanggal 19 Maret 2024 pada usia kehamilan ibu 39 minggu 3 hari. Asuhan yang diberikan sesuai dengan standar 60 langkah Asuhan Persalinan Normal (APN), didapatkan kala I berlangsung selama 5 jam 20 menit, dan kala II berlangsung selama 27 menit, dilakukan penilaian sepintas, bayi lahir cukup bulan, segera menangis, warna kulit kemerahan, dan tonus otot baik. Kala III berlangsung salama 8 menit setelah oksitosin disuntikkan, plasenta lahir lengkap dan tidak ada kelainan dan robekan. Asuhan kebidanan pada kala IV dilakukan selama 2 jam dengan memantau Tanda-Tanda Vital (TTV) ibu, dan didapatkan hasil dalam batas normal, perdarahan kurang lebih 100 cc, terdapat laserasi perineum derajat 2 dan telah dilakukan penjahitan dengan anastesi. Kunjungan nifas dan bayi baru lahir dilakukan pada tanggal 20 Maret 2024, dengan hasil pemeriksaan fisik dan TTV ibu dan perdarahan masa nifas dalam batas normal, Tinggi Fundus Uteri (TFU) 2 jari dibawah pusat, terdapat pengeluaran lochea rubra dan bekas jahitan perineum masih basah dan tidak ada tanda-tanda infeksi. Asuhan yang dilakukan pada bayi baru lahir berupa pengkuran antropometri. Didapatkan hasil bayi berjenis kelamin perempuan, berat badan 3.000 gr, panjang badan 48 cm, lingkar kepala 32 cm, dan lingkar dada. Telah dilakukan asuhan komprehensif pada Ny. N selama masa kehamilan, persalinan, nifas, dan bayi baru lahir dengan didapatkan bahwa tidak terdapat penyulit dan berlangsung fisiologis. Asuhan kebidanan yang berkelanjutan jika diberikan secara aktif dapat meningkatkan kesehatan ibu dan anak.
Comprehensive Midwifery Services are midwifery care services that are carried out comprehensively starting from pregnancy, childbirth, postpartum to newborns. The aim of this midwifery service is to be able to detect what happens to a woman from pregnancy, childbirth, the birth of a baby to the postpartum period as well as training how to carry out assessments, provide an accurate diagnosis, anticipate problems that may arise, determine immediate action, plan and act according to the mother's needs and be able to evaluate the actions taken. Comprehensive midwifery care or Continuity Of Care carried out by the author begins in the third trimester of pregnancy, delivery, postpartum and newborn babies on an ongoing basis using standard midwifery care. Care is provided from March 18 2024 – March 20 2024. Midwifery care visits are carried out at the Amal Beach Community Health Center. Pregnancy visits are carried out once, maternity visits once, postpartum and newborn visits once. So the author carried out comprehensive visits four times. Comprehensive midwifery care was first carried out during a pregnancy visit in the third trimester on March 18 2024 with the mother's gestational age being 39 weeks 2 days, obtained after an assessment was carried out from the pregnancy visit in normal conditions and no complications were found. Maternity care was provided on March 19 2024 at the mother's gestational age of 39 weeks 3 days. The care provided was in accordance with the standard 60 steps of Normal Childbirth Care (APN), it was found that the first stage lasted 5 hours 20 minutes, and the second stage lasted 27 minutes, a cursory assessment was carried out, the baby was born full term, immediately cried, the skin color was reddish, and good muscle tone. The third stage lasted 8 minutes after oxytocin was injected, the placenta was born complete and there were no abnormalities or tears. Midwifery care in the IV stage was carried out for 2 hours by monitoring the mother's Vital Signs (TTV), and the results were within normal limits, bleeding was approximately 100 cc, there was a grade 2 perineal laceration and suturing had been carried out under anesthesia. Postpartum and newborn visits were carried out on March 20 2024, with the results of physical examination and mother's TTV and puerperal bleeding within normal limits, uterine fundus height (TFU) 2 fingers below the center, there was lochea rubra discharge and the perineal suture marks were still wet and no signs of infection. The care provided for newborns takes the form of anthropometric measurements. The results showed that the baby was female, weighing 3,000 grams, body length 48 cm, head circumference 32 cm and chest circumference. Comprehensive care has been provided for Mrs. N during pregnancy, childbirth, postpartum and newborns with the result that there are no complications and it is physiological. Sustainable midwifery care, if provided actively, can improve the health of mothers and children.