Having established the Nursing's. S System Digestive disorders: Post Surgery Colostomy A / i Atresia Ani in the room RB2A Surgery Children's Hospital Medan human rights, in this chapter the author discusses the gap between the theoretical basis and the foundation of the case to be more effective so as to achieve optimum goal.
In this discussion the authors found several kesenjangn between theoritical and actual case reviews in the nursing process from assessment, diagnosis, planning, implementation and evaluation.
4.1 ASSESSMENT
At this stage the author gets real data by carrying out communication with the patient's family, observing the patient, perform a physical examination, and read the documentation of the patient so that the problem which includes bio-psycho social and spiritual can be assessed and collected in a comprehensive manner.
The gaps are at the stage of assessment between cases and tinajuan theoretical tinajuan are:
1. On theoritical found penkajian on gastrointestinal and integument while on a review of cases, the assessment riwyat birth, medical history, growth and development, examination of Head To Toe and patterns of daily habits and knowledge of parents to the disease, the causes of disease and the condition of the home environment .
4.2 Diagnosis
In a review of theoretical nursing diagnosis found a few, namely:
1. Impaired skin integrity
2. Risk of infection
3. Changes in nutrition less than body requirements
4. High risk of diarrhea / constipation
5. Body image disturbance
6. Painful
Whereas in the case found only 3 diagnoses, namely:
1. Impaired sense of comfort: pain
2. Changes in nutrition less than body requirements
3. damage to skin integrity
4.3 PLANNING
Interventions that exist in theory but is absent in the case of:
1. Teach the patient breathing for the patient is a child under the age of 5 days.
2. Identify favorite foods and foods that do not like children because milk only diet
3. Encourage the patient to perform a high seating position / semi-Fowler position and avoid sitting too long Since the patients are children aged 6 months who have not been able to sit alone.
4. Encourage the patient to say masalah.Mendengarkan actively and about providing support to the reception given the patient and provide appropriate information. Since the patient is not able to speak.
While the interventions were found in the case but not ditemikan the theory are:
1. Encourage the family to control the activity of the patient. This is done by seeing the patient is a child restless and not able to understand the situation that was recently completed operation.
4.4 IMPLEMENTATION
At the implementation stage keperawata many authors do not find it difficult because of the patient's family cooperated with the author that all the questions submitted by the author answered by the patient's family to ease the author to obtain information about the patient's illness.
4.5 EVALUATION
At this stage, the authors will discuss the gap between the case and theory. Basically treatments performed on patients emphasized effective, professional, able to perform therapy ith good physical condition and good shape anyway. At this stage of the evaluation objectives have been achieved only in part, because after the evaluation found:
1. At first diagnosis, namely: "Pain" objectives are achieved in part by mild pain scale criteria, namely: 2
2. At diagnosis to 2 that: "Damage to skin integrity" objective criteria tercapi part with the skin still looks rosy
3. At diagnosis to 3, namely: "the change in nutrition less than body requirements" objective criteria is achieved partly by the child's weight was 2.5 kg.
In this discussion the authors found several kesenjangn between theoritical and actual case reviews in the nursing process from assessment, diagnosis, planning, implementation and evaluation.
4.1 ASSESSMENT
At this stage the author gets real data by carrying out communication with the patient's family, observing the patient, perform a physical examination, and read the documentation of the patient so that the problem which includes bio-psycho social and spiritual can be assessed and collected in a comprehensive manner.
The gaps are at the stage of assessment between cases and tinajuan theoretical tinajuan are:
1. On theoritical found penkajian on gastrointestinal and integument while on a review of cases, the assessment riwyat birth, medical history, growth and development, examination of Head To Toe and patterns of daily habits and knowledge of parents to the disease, the causes of disease and the condition of the home environment .
4.2 Diagnosis
In a review of theoretical nursing diagnosis found a few, namely:
1. Impaired skin integrity
2. Risk of infection
3. Changes in nutrition less than body requirements
4. High risk of diarrhea / constipation
5. Body image disturbance
6. Painful
Whereas in the case found only 3 diagnoses, namely:
1. Impaired sense of comfort: pain
2. Changes in nutrition less than body requirements
3. damage to skin integrity
4.3 PLANNING
Interventions that exist in theory but is absent in the case of:
1. Teach the patient breathing for the patient is a child under the age of 5 days.
2. Identify favorite foods and foods that do not like children because milk only diet
3. Encourage the patient to perform a high seating position / semi-Fowler position and avoid sitting too long Since the patients are children aged 6 months who have not been able to sit alone.
4. Encourage the patient to say masalah.Mendengarkan actively and about providing support to the reception given the patient and provide appropriate information. Since the patient is not able to speak.
While the interventions were found in the case but not ditemikan the theory are:
1. Encourage the family to control the activity of the patient. This is done by seeing the patient is a child restless and not able to understand the situation that was recently completed operation.
4.4 IMPLEMENTATION
At the implementation stage keperawata many authors do not find it difficult because of the patient's family cooperated with the author that all the questions submitted by the author answered by the patient's family to ease the author to obtain information about the patient's illness.
4.5 EVALUATION
At this stage, the authors will discuss the gap between the case and theory. Basically treatments performed on patients emphasized effective, professional, able to perform therapy ith good physical condition and good shape anyway. At this stage of the evaluation objectives have been achieved only in part, because after the evaluation found:
1. At first diagnosis, namely: "Pain" objectives are achieved in part by mild pain scale criteria, namely: 2
2. At diagnosis to 2 that: "Damage to skin integrity" objective criteria tercapi part with the skin still looks rosy
3. At diagnosis to 3, namely: "the change in nutrition less than body requirements" objective criteria is achieved partly by the child's weight was 2.5 kg.
