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Asuhan Keperawatan Pada Klien Dengan Isos

Asuhan Keperawatan Pada Klien Dengan Isos

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TUGAS

KEPERAWATAN JIWA I
ISOLASI SOSIAL
Diajukan Sebagai Salah Satu Syarat Untuk Mendapatkan Nilai Mata Kuliah Keperawatan Jiwa I
Oleh :
Najmal Hadi Zain
NIM 08!"80#
$%&en :
Ns.Novi Herawati,S.Kep
POLITEKNIK KESEHATAN $EPKES RI PA$ANG
PRO$I KEPERAWATAN SOLOK
!00'(!0"0
KATA PENGANTAR
Puji syukur penulis ucapkan kepada Allah SWT yang senantiasa elipahkan rahat dan
karunia!Nya kepada penulis terutaa dala penyusunan akalah ini , sehingga akalah yang
"erjudul I&%la&i S%&ial dapat penulis selesaikan. #akalah ini diajukan untuk eenuhi tugas
ata kuliah Keperawatan $iwa % tahun ajaran &''()&'*'.
+ala penulisan akalah ini penulis "anyak di "antu oleh "er"agai pihak terutaa dosen
pe"i"ing %"u Ns.Novi Herawati S. Kep, tean!tean dan "er"agai pihak yang turut
e"antu penulis sehingga akalah ini dapat diselesaikan.
Penulis enyadari "ahwa akalah ini asih jauh dari sepurna. ,leh karena itu, penulis
engharapkan kritik dan saran dari pe"aca agar dapat enyepurnakan akalah ini. Seoga
akalah ini dapat "eran-aat "agi para pe"aca.
Solok, *( Septe"er &'*'
Penulis
)A) II
ASUHAN KEPERAWATAN PA$A KLIEN $ENGAN
GANGGUAN ISOLASI SOSIAL : MENARIK $IRI
A*KONSEP $ASAR
%solasi adalah keadaan diana individu atau kelopok engalai atau erasakan
ke"utuhan atau keinginan untuk eningkatkan keterli"atan dengan orang lain tetapi tidak
apu untuk e"uat kontak . /arpenito, *((0 1 %solasi sosial adalah suatu keadaan kesepian
yang dialai oleh seseorang karena orang lain enyatakan sikap yang negati- dan enganca
.Towsend,*((01
Seseorang dengan perilaku enarik diri akan enghindari interaksi dengan orang lain.
%ndividu erasa "ahwa ia kehilangan hu"ungan akra" dan tidak epunyai kesepatan untuk
e"agi perasaan, pikiran dan prestasi atau kegagalan. %a epunyai kesulitan untuk
"erhu"ungan secara spontan dengan orang lain, yang dianivestasikan dengan sikap
eisahkan diri, tidak ada perhatian dan tidak sanggup e"agi pengalaan dengan orang lain
.+epKes, *((01.
)*+AKTOR PRE$ISPOSISI $AN PRESIPITASI
2aktor predisposisi terjadinya perilaku enarik diri adalah kegagalan perke"angan
yang dapat engaki"atkan individu tidak percaya diri, tidak percaya orang lain, ragu takut salah,
putus asa terhadap hu"ungan dengan orang lain, enghindar dari orang lain, tidak apu
eruuskan keinginan dan eresa tertekan.
Sedangkan -aktor presipitasi dari -aktor sosio!cultural karena enurunnya sta"ilitas
keluarga dan "erpisah karena eninggal dan -akto psikologis seperti "erpisah dengan orang yang
terdekat atau kegagalan orang lain untuk "ergantung, erasa tidak "erarti dala keluarga
sehingga enye"a"kan klien "erespons enghindar dengan enarik diri dari lingkungan .Stuart
and sundeen, *((31.
,* TAN$A $AN GEJALA
,"servasi yang dilakukan pada klien akan diteukan .data o"jekti-1 4
*. Apatis, ekspresi, a-ek tupul.
&. #enghindar dari orang lain .enyendiri1 klien tapak eisahkan diri dari orang lain.
5. Kounikasi kurang atau tidak ada. Klien tidak tapak "ercakap!cakap dengan klien lain
atau perawat.
6. Tidak ada kontak ata, klien le"ih sering enunduk.
3. 7erdia diri di kaar)tepat "erpisah 8 klien kurang o"ilitasnya.
9. #enolak hu"ungan dengan orang lain 8 klien eutuskan percakapan atau pergi jika
diajak "ercakap!cakap.
:. Tidak elakukan kegiatan sehari!hari, artinya perawatan diri dan kegiatan ruah tangga
sehari!hari tidak dilakukan.
0. Posisi janin pada saat tidur.
+ata su"jekti- sukar didapat jika klien enolak "erkounikasi, "e"erapa data su"jekti-
adalah enjawa" dengan singkat kata!kata ;tidak<, ;ya<, ;tidak tahu<.
$*KAREKTERISTIK PERILAKU
*. =angguan pola akan 4 tidak na-su akan atau akan "erle"ihan.
&. 7erat "adan enurun atau eningkat secara drastis.
5. Keunduran secara -isik.
6. Tidur "erle"ihan.
3. Tinggal di tepat tidur dala waktu yang laa.
9. 7anyak tidur siang.
:. Kurang "ergairah.
0. Tidak eperdulikan lingkungan.
(. Kegiatan enurun.
*'. %o"ilisasai.
**. #ondar!andir .sikap eatung, elakukan gerakan "erulang1.
*&. Keinginan seksual enurun.
)A) III
KONSEP $ASAR ASUHAN KEPERAWATAN KESEHATAN JIWA PA$A KLIEN
$ENGAN GANGGUAN ISOLASI SOSIAL - MENARIK $IRI*
%. $ESKRIPSI
Tanggapan atau deskripsi tentang isolasi yaitu suatu keadaan kesepian yang dialai oleh
seseorang karena orang lain enyatakan sikap yang negati- dan enganca .towsend,
*((01.
Seseorang dengan perilaku enarik diri akan enghindari interaksi dengan orang lain.
%%. PENGKAJIAN
Pengelopokan data pada pengkajian kesehatan jiwa "erupa -aktor presipitasi, penilaian
stressor , su"erkoping yang diiliki klien. Setiap elakukan pengajian ,tulis tepat
klien dirawat da tanggal dirawat isi pengkajian eliputi 4
A* I$ENTITAS KLIEN
#eliputi naa klien , uur , jenis kelain , status perkawinan, agaa, tangggal #>S ,
in-oran, tangggal pengkajian, No >uah klien dan alaat klien.
)*KELUHAN UTAMA
Keluhan "iasanya "erupa enyediri .enghindar dari orang lain1 kounikasi kurang
atau tidak ada , "erdia diri dikaar ,enolak interaksi dengan orang lain , tidak
elakukan kegiatan sehari 8 hari , dependen.
,* +AKTOR PRE$ISPOSISI
Kehilangan , perpisahan , penolakan orang tua ,harapan orang tua yang tidak realistis
,kegagalan ) -rustasi "erulang , tekanan dari kelopok se"aya? peru"ahan struktur sosial.
Terjadi traua yang ti"a ti"a isalnya harus dioperasi , kecelakaan dicerai suai , putus
sekolah ,PHK, perasaan alu karena sesuatu yang terjadi . kor"an perkosaan , tituduh
kkn, dipenjara ti"a 8 ti"a1 perlakuan orang lain yang tidak enghargai klien) perasaan
negati- terhadap diri sendiri yang "erlangsung laa.
$*ASPEK +ISIK ( )IOLOGIS
Hasil pengukuran tada vital .T+, Nadi, suhu, Pernapasan , T7, 771 dan keluha-isik yang
dialai oleh klien.
E*ASPEK PSIKOSOSIAL
1. Genogram yang menggambarkan tiga generai
!. Konep diri
a1 citra tu"uh 4
#enolak elihat dan enyentuh "agian tu"uh yang "eru"ah atau tidak eneria
peru"ahan tu"uh yang telah terjadi atau yang akan terjadi.#enolak penjelasan
peru"ahan tu"uh , persepsi negatip tentang tu"uh .
Preokupasi dengan "agia tu"uh yang hilang , engungkapkan keputus asaan,
engungkapkan ketakutan.
"1 %dentitas diri
Ketidak pastian eandang diri , sukar enetapkan keinginan dan tidak apu
enga"il keputusan .
c1 Peran
7eru"ah atau "erhenti -ungsi peran yang dise"a"kan penyakit , proses enua ,
putus sekolah, PHK.
d1 %deal diri
#engungkapkan keputus asaan karena penyakitnya 4 engungkapkan keinginan
yang terlalu tinggi.
e1 Harga diri
Perasaan alu terhadap diri sendiri , rasa "ersalah terhadap diri sendiri , gangguan
hu"ungan sosial , erendahkan arta"at , encederai diri, dan kurang percaya diri.
". Klien mempunyai gangguan # hambatan dalam melakukan hubunga oialdengan
orang lain terdekat dalam kehidupan$ kelempok yang diikuti dalam mayarakat.
%. kenyakinan klien terhadap tuhan dan kegiatan untuk ibadah & pritual'
+* STATUS MENTAL
Kontak ata klien kurang )tidak dapat epertahankan kontak ata , kurang dapat
eulai pe"icaraan , klien suka enyendiri dan kurang apu "erhu"ungan denga
orang lain , Adanya perasaan keputusasaan dan kurang "erharga dala hidup.
G* KE)UTUHAN PERSIAPAN PULANG*
*. Klien apu enyiapkan dan e"ersihkan alat akan
&. Klien apu 7A7 dan 7AK, enggunakan dan e"ersihkan W/, e"ersikan
dan erapikan pakaian.
5. Pada o"servasi andi dan cara "erpakaian klien terlihat rapi
6. Klien dapat elakukan istirahat dan tidur , dapat "eraktivitas didala dan diluar
ruah
H* MEKANISME KOPING
Klien apa"ila endapat asalah takut atau tidak au enceritakan nya pada orang
orang lain. le"ih sering enggunakan koping enarik diri1
I* AS+EK ME$IK
Terapi yang diteria klien "isa "erupa therapy -arakologi @/T, Psikootor,therapy
okopasional, TAK , dan reha"ilitas.
III* $IAGNOSA KEPERAWATAN
+iagnosa Keperawatan adalah identi-ikasi atau penilaian pola respons "aik aktual
aupun potensial .Stuart and Sundeen, *((31
#asalah keperawatan yang sering uncul yang dapat disipulkan dari pengkajian
adalah se"agai "erikut 4
A. %solasi sosial 4 enarik diri
A. =angguan konsep diri4 harga diri rendah
A. >esiko peru"ahan sensori persepsi
A. Koping individu yang e-ekti- sapai dengan ketergantungan pada orang lain .
A. =angguan kounikasi ver"al, kurang kounikasi ver"al.
A. %ntoleransi akti-itas.
A. Kekerasan resiko tinggi.
Pohon Masalah
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36f10d3d4d8401414f0b
+iagnosa Keperawatan
*. >esiko peru"ahan sensori persepsi "erhu"ungan dengan enarik diri.
&. %solasi sosial 4 enarik diri "erhu"ungan dengan harga diri rendah
5. =angguan harga diri 4 harga diri rendah "erhu"ungan dengan tidak e-ekti-nya koping
individu 4 koping de-ensi-.
I.* TIN$AKAN KEPERAWATAN
Tindakan keperawatan dala asuhan keperawatan jiwa "er"eda dengan tindakan
keperawatan untuk klien dengan penyakit -isik di >SB dala perawatan kesehatan jiwa.
Perawat elakukan tindakan yang "ertujuan untuk engatasi penye"a" dari asalah
dan da-tar asalah diatas dapat dia"il salah satu. /ontoh asalah keperawatan yaitu 4
resiko peru"ahan sensori persepsi "erhu"ungan dengan isolasi sosial 4 enarik diri.
.* REN,ANA INTER.ENSI
>encana tindakan keperawatan terdiri 5 as-ek utaa yaitu 4
a. tujuan uu
"er-okus pada penyelesaian perasalahan dari diagnosa. Tujuan uu dapat dicapai
jika serangkaia tujuan khusus dapat dicapai.
". tujuan khusus
"er-okus pada penyelesaian etiologi dari diagnosa. Tujuan khusus erupakan ruusan
keapuan klien yang perlu dicapai atau diiliki klien .uunya keapuan pada
tujuan khusus dapat di"agi enjadi 5 aspek .stuart C sundeen ,*((31 yaitu 4 keapuan
kogniti- yang diperlukan untuk enyelesaikan etiologi dari diagnosa keperawatan
,keapuan psikootor yang diperlukan agar etiologi dapat selesai dan keapuan
a-ekti- yang perlu diiliki agar klien percaya akan keapuan enyelesaiakan
asalah.
c. >encana tindakan keperawatan
Tindakan keperawatan erupakan serangkaian tindakan yang dapat encapai tujuan
khusus. tindakan keperawatan engga"arkan tindakan keperawatan andiri,
kerjasaa dengan klien, keluarga, kelopok dan kola"orasi dengan ti kesehatan jiwa
lainnya.
d. Kriteria @valuasi keperawatan
Kriteria evaluasi di"uat "erdasarkan pada tujuan khusus yang terdiri dari "e"erapa
tujuan , asing tujuan terse"ut ada kriteria evaluasinya .
$A+TAR PUSTAKA
/arpenito, lynda $uall. *((0. 7uku saku "uku kedokteran @=/ 4 jakarta.
Keliat, 7.A. *(((. Proses keperawatan kesehatan jiwa, pener"it "uku kedokteran
@=/ 4 diagnosa keperawatan , @disi 9, pener"it $akarta.
Short, =.W dan Sandra, $. Sunden. *((0. 7uku Saku Keperawatan $iwa, @disi 5,
pener"it "uku kedokteran @=/4 $akarta.
Towsend, #ary /. *((0. 7uku saku +iagnosa keperawatan psikiatri untuk
pe"uatan rencana keperawatan, @disi 5, Pener"it "uku kedokteran @=/4 $akarta.
!!!!!!!!!!!, *((0. 7uku Standart keperawatan Kesehatan $iwa dan penerapan asuhan
keperawatan pada kasus di >uah Sakit Ketergantungan o"at, +irektorat kesehatan
jiwa +irektorat $enderal Pelayanan edik, +ep!kes >%, $akarta.
http))google.co.idDaskep isolasi social.htl.

KATA PENGANTAR

Puji syukur penulis ucapkan kepada Allah SWT yang senantiasa melimpahkan rahmat dan karunia-Nya kepada penulis terutama dalam penyusunan makalah ini , sehingga makalah yang berjudul Isolasi Sosial dapat penulis selesaikan. Makalah ini diajukan untuk memenuhi tugas mata kuliah Keperawatan Jiwa I tahun ajaran 2009/2010. Dalam penulisan makalah ini penulis banyak di bantu oleh berbagai pihak terutama dosen pembimbing Ibu Ns.Novi Herawati S. Kep, teman-teman dan berbagai pihak yang turut membantu penulis sehingga makalah ini dapat diselesaikan. Penulis menyadari bahwa makalah ini masih jauh dari sempurna. Oleh karena itu, penulis mengharapkan kritik dan saran dari pembaca agar dapat menyempurnakan makalah ini. Semoga makalah ini dapat bermanfaat bagi para pembaca.

Solok, 19 September 2010

Penulis

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