PENERAPAN KOMBINASI POSISI SEMI FOWLER DAN LATERAL KANAN DENGAN PENURUNAN CURAH JANTUNG PADA PASIEN GAGAL JANTUNG DI RUMAH SAKIT TK II PUTRI HIJAU MEDAN

Abstract

Heart failure is the inability of the heart to pump blood according to the body's needs, characterized by decreased cardiac output. Heart failure can cause swelling of the legs or arms, hypoxemia, shortness of breath, stroke, and may lead to death. A non-pharmacological therapy that can be administered to patients with heart failure is the application of the semi-Fowler and right lateral positions for 15 minutes. This therapy aims to increase cardiac output. Objective: This research aims to determine the description of the application of a combination of the semi-Fowler and right lateral positions in relation to decreased cardiac output in patients with heart failure at TK II Putri Hijau Hospital, Medan. Methods: This research employed a descriptive method with a case study approach involving two patients with heart failure. The research data were obtained through interviews, observations and physical examinations, documentation studies, and questionnaires, as well as data collection using a nursing care assessment format. Nursing care was assessed based on the processes of assessment, diagnosis, intervention, implementation, and evaluation. The nursing problem identified in this research was Decreased Cardiac Output (D.0008). The intervention performed was the application of the semi-Fowler and right lateral positions. The implementation was carried out for 3 days, for 15 minutes in each session, according to the established procedure. Results: Patient 1 before the therapy was administered had blood pressure (BP) of 170/102 mmHg, respiratory rate (RR) of 28 breaths/minute, heart rate (HR) of 120 beats/minute, oxygen saturation (SpO2) of 91%, and mean arterial pressure (MAP) of 125 mmHg. After the therapy was administered, the patient's BP was 130/85 mmHg, RR was 20 breaths/minute, HR was 84 beats/minute, SpO2 was 96%, and MAP was 100 mmHg. Patient 2 before the therapy was administered had BP of 180/136 mmHg, RR of 24 breaths/minute, HR of 101 beats/minute, SpO2 of 92%, and MAP of 150.67 mmHg. After the therapy was administered, the patient's BP was 135/85 mmHg, RR was 20 breaths/minute, HR was 88 beats/minute, SpO2 was 97%, and MAP was 101.7 mmHg. Conclusion: The application of a combination of the semi-Fowler and right lateral positions is effective in increasing cardiac output and resolving nursing problems in patients with heart failure.