CHAPTER I
INTRODUCTION

A. Background
Family nursing care is a series kegitatan given via the practice of nursing in the family. Family nursing care used to help resolve problems with the family health nursing process approach. Health services provided in order to be accepted by the family, the nurse: - Must understand, understand the type and structure of the family - Know the level of achievement of the family in performing its functions. - Need to understand each stage of family development and job development assessment was conducted to determine the extent to which families meet perkembangnya task. New partner (family-friendly):
When the individual men and women form:
1. Family via marriage are legitimate and leave their families.
2. Prepare for the new family.
3. Need penyesuaianan the role and functions of day-to-day
4. Learning to live together, to adapt to the habits of their own and their partner.
Family is two or more individuals who live in the house because of the ties of blood, marriage or adoption of interacting, and each has a role to create and sustain a culture (Bailon & Maglaya).
Family nursing care is a series kegitatan given via the practice of nursing in the family. Family nursing care used to help resolve problems with the family health nursing process approach. Health services provided in order to be accepted by the family, the nurse:

    Should know, understand and type of family structure.
     Know the level of achievement of the family in performing its functions.
    Need to understand each stage of family development and development tasks


                The assessment was conducted to determine the extent to which families meet first task perkembangnya.Tahun-year marriage were years of adaptation. It was the opinion of the observers and commentators about marriage and family. People generally think of it as a honeymoon period, indicating romatisme, the impression will be the sweet days that will pass.


B. Destination
1. General Purpose
      To know the nursing care to families newly married couples
2. Specific Objectives
             To find a new understanding of my family married couples, the task of development
      newly married couple families, assessment and family problems on a new partner
      married.
 

CHAPTER II
DISCUSSION
Nursing New Married Couple Families with Problems KB
A. Definition

Whall (1986) in the analysis of the concept of the family as a unit that needs to be treated, it defines a family as a group to identify with members consisting of two or more individuals whose association is characterized by specific terms, which may not be bound by ties of blood or law, but which functions in such a way that they think of themselves as a family.

Family Service America (1984) defines the family in a comprehensive way, namely as "two or more people who are united by the bonds of togetherness and intimacy".

Hariyanto, 2005. family refers to two or more people who are united by the bonds of togetherness and emotional bond and who identify themselves as part of the family.

Friedman 1998, the family is a collection of two people / more alive with dg attachment and emotional regulation, and each individual has their respective roles. While the newly married couple is when a man and woman to form a family through legal marriage and leave their families.

B. Phase - phase newly married spouse
Ø
                  When the individual men and women to form families via
           legal marriage and leave their families. Prepare
           new family. Need penyesuaianan the role and functions of everyday life Learning
           together, adapting to its own and partner's habits. Members of the three
           family is family, husband, wife and family of his own. Each face
           parents' separation from families, to establish new relations with family
           and social groups couples
Ø
                   That need to be decided: when the right time to get the kids and the amount of
           expected

C. Problems usually done by a newly married couple
Ø Do not face the problem of debt
                      Apparently, according to data from thenest.com, financial problems are the most important issues in question by the couple. If you are married, then you'll want to pull out and express all your perutangan problems, yet she is your partner, there is nothing to be covered up, but need to be dealt with. Then, try counting your finances and plan for the future. If necessary, meet expert financial planner.
Ø Isolation of friendship
                 Friends is key to the success of the marriage. So, do not alienate yourself from them. If your friends are single gathering, make sure everything's in a safe at home, then come along to go along with them, of course with the permission of the husband. Just because you did not get involved in the club flirting with a man does not mean you can not be supportive.
Ø Not enough sex
                  As many as 60 percent of newly married couples who responded to the survey said that their sex life a mess. Most reasons, busy, of course. However, it is not a sufficient reason for making love in bed with your partner, right? Try to initiate sex with a partner event. In fact, if necessary, make the schedule. If you start to get used to do it, then you will want more, there might be more like it as well.
Ø Do not keep the body
                  Have you ever noticed, usually the people who just got married would look more "prosperous" in terms of weight? Yes, for some reason, this always happens. Perhaps because of the habit of drinking or eating at night or fatigue-exhaustion due to busy at night so
in the morning for breakfast so much spirit in large quantities. Wow, this must be wary. You should begin to propagate an agenda for exercising with friends. Do not want, do not you, that he felt you did not look fresh or look more plump than before marriage?
Ø-law and brother in law
                    Fifty percent of couples surveyed by thenest.com have problems with their in-laws and brother in law. Try to set expectations, as you will come visit with p `` `` `` `` `` `` `` `` Ultimately, it will come back to haunt you.
Ø The quarrel is not important
                     You know, sometimes living under the same roof with the person you think you already know it could be very confusing. Try not easily provoked anger. However, if it is the emotion of anger has peaked, say excuse me, say that you need time for yourself first. Calm yourself for a moment. Make sure you are in a state of calm and cool head when trying to resolve problems. When emotions, calm your mind and can not be saying things that did not mean that you can only exacerbate the problem.
Ø Obsessed with babies
                 Of course, like to have a baby is the next big step in life after marriage. However, calm down, do not rush and become obsessed to have it soon. On average, couples have a baby within the first 3 years of their marriage. So, why the rush? Enjoy your time with friends, vacationing together, enjoy time without the hassles will be cheerful about the baby needs, and others. After all, when you are in a relaxed state, the possibility of the presence of the baby even more.

D. The development tasks
Members of three families, namely family, husband, wife Danu Each face parting with keluargaükeluarga own. parents, to establish new relations with families and couples social group
That need to be decided: when the right time to get the expected number of children and family-friendly development tasks:
1. Satisfying intimate relationships.

    Will set up a new life together
    The sources of the two combined.
    Changing roles.
    New function is received.
    Learn to live together as they meet the basic needs of personality.
    Mensesuaikan themselves against each other little things that are routine success in developing relationships occur when both partners mutually adjust and match the needs and interests of the couple.

Network connecting fraternity in harmony.
Couples face the task of separating themselves from the family of origin and seek a relationship with the parents of the spouse and other family. Primary loyalty must be changed for the sake of her marriage.
3. Discuss plans to have children or choose KB.
Health problems that sexual adjustment and marital role. Nurses Nurses in Family planning in family planning nurse's role is to assist couples to choose the right contraceptive method to be used in accordance with the conditions, trends, socio-cultural and beliefs held by the couple, and therefore the nursing process is more geared to help couples choose the method of contraception itself.

Failure occurs due to the use of methods kontrasespsi woman's lack of knowledge of the instrument itself kontrasespsi giving effect to physiological conditions, psychological, and cultural life sosilaL against pregnancy. then this is where the role of nurses to provide proper knowledge, so that the above does not happen. Assessment Due to issues of contraception is a sensitive issue for women, so in this case the nurse should assess very concerned about the privacy of clients. Lower your voice when assessing clients for improving comfort and maintain high confidence that client.

In addition to the general assessment (client identity, medical history, history obgyn), special assessments we need to do to fulfill the role as an educator in the selection of appropriate methods of contraception are: Knowledge of the client about the various methods of contraception
The assessment is done by asking when she is planning to have a child. Then ask what methods are planned to be used by the client. If the client states of the type / method, the nurse may ask the reason for the use of such methods. These questions will identify the problems faced by clients associated with contraceptive use.
2. Knowledge of techniques of use of contraceptive methods
In carrying out its role as a nurse educator must be able to determine the client's level of knowledge about the use of contraceptive techniques. For example, ask about how the client is using a diaphragm, spermicide when and where it is applied or how many times a day the client should be taking birth control pills to explore the level of knowledge of the client, the nurse can determine if there are misperceptions in the use of which would lead to ineffective use of contraception and will result in an unplanned pregnancy.
3. Comfort of the client's contraceptive method that is being used.
In reviewing the client's comfort, listen to the complaints of side effects of contraceptive use. Listen also a statement about the client's comfort monthly use of contraceptive methods such as injectable hormone pills of the family planning that should be consumed every day. The effectiveness of a method to increase with increasing client comfort in using these methods.
4. The factors supporting the use of appropriate methods
If the client plans to replace discuss contraceptive methods on options suitable for use. Assess the factors that can help the selection of the best methods such as the client's medical history before a contraindication of methods of contraception, obstetric history, culture and beliefs as well as the desire to prevent pregnancy.

The contraindications to the use of contraceptive methods related to medical history is
 a. Oral contraceptives
1) integrated family planning pill
History of tuberculosis, seizures, breast cancer, breast lumps, late period, pregnancy, abnormal bleeding, hepatitis, heart disease, tromboplebitis. For female smokers, aged more than 35th, people with diabetes, epilepsy, and patients with hypertension is not recommended to use birth control pills.
2) Mini Pill
Mini pill should not be used in women who have to avoid any kind of hormonal methods, or the treatment of seizures mejalani
b. Hormonal Contraception
1) Hormone Implants
Cancer / hard lumps in the breast, missed period, pregnancy, bleeding of unknown cause, heart disease and a desire to become pregnant is less than five years.
2) Hormone Injection
Integrated injections should not be given to women during lactation.
c. Mechanical contraceptives
1) The diaphragm and cervical cap and the diaphragm cervical cap is not used in women with a history of latex allergy and a history of toxic shock syndrome.
2) IUD Pregnant or possibly pregnant, high risk of diseases transmitted through sexual intercourse, history of reproductive infections, infections after delivery / abortion, ectopic pregnancy, metroragia Dismenorhea, anemia and had never been pregnant, mola.
d. Contraception Settled
Contraception is no contraindication, because it is permanent. Used for couples who are not wanted or are not allowed to have children Data Analysis Lack of knowledge about family planning is the most common cause of physical, psychological and social in relation to unplanned pregnancy.

E. Nursing Assessment
Stage that needs to be done:

     Bhsp
    Introduce
    Explain the purpose of the visit
    Focuses on the family life cycle
    Family history from birth
    Assess stress that befall his family and the actual problems of potential
    The development of the current family
    Ask your experiences and common tasks, how the results
    achieved, it was felt.
    Ask relationship in the past and present with their family orientation and shape àMmemberi life Nurses: an understanding of them during their formative years.
    The extent to which families meet development tasks
    Gali family history: the first meeting couples, premarital relationships, barriers to marriage, the response to his marriage,


F. Nursing Diagnosis
Diagnoses based on assessment and data is
    Changes in Health Care Risks associated with less knowledge Against Contraception Method Selection and availability. While other nursing diagnoses that may arise are:

    Risk of conflict decision-making contraceptive alternative bd
    B.d fear of side-effects
    High risk of infection bd sexually active conditions and the use of contraceptive methods
    High risk of changes in the pattern of sexuality bd afraid of getting pregnant
    Spiritual distress bd religious beliefs or cultural incompatibility with the chosen contraceptive method Intervention Plan


G. Nursing Interventions
1. Changes in Health Care Risks associated with less knowledge Against Contraception Method Selection and availability.

           Criteria results

           After the intervention, the couple will:

           Correctly describe how the use of contraceptive methods chosen and solving the problem
           Can explain the side effects and complications of the chosen contraceptive method.
          Reported satisfaction with the contraceptive method chosen.
          Describes other methods that can be used and select one of these methods if the couple replace wantid contraceptive method.

b. Intervention
1) Stimulate awareness or acceptance of the family health problems and needs in a way about providing the information, identify the needs and expectations of health, and encouraging healthy emotional attitude towards the problem.
2) Stimulate the family to decide how to appropriate care by identifying the consequences of not taking action, mengidentfikasi sources - family owned sources and discuss about konsukensi each action.
3) Giving confidence in the care of family members who sakait by demonstrating how to care, use of existing equipment and facilities at home and watching the family do care
Intervention in general are biased do nurses
· The goal is to help families and members move toward the completion of developmental tasks of individuals and families.
· Mastery of a collection of family developmental tasks memunginkan families move forward towards the next stage of development.
· If the tasks are not met then the family developments dysfunctional family.
· Provide counseling to families about the process of family development.
· Helping families achieve and maintain a balance between the needs and the personal growth of individual family members and the optimum function (growth needs of the family).
· Guiding anticipation and counseling to achieve the goal of primary prevention.
· Helping family anticipate and pass through different normative transitions in family life.



REFERENCES
Tri Agustiansyah Aan. Nursing 2009.Asuhan New Married Couple Families with Problems KB. Nursing is a perfect proffesion. (Http://ners86.wordpress.com accessed on October 24, 2010)
www.nusaindah.tripod.com
www.olx.co.id
Http :/ / yudhim.blogspot.com/2008/02 /