Pemenuhan Kebutuhan Eliminasi Pada Inkontinensia Urine Dengan Kegel Exercise Di UPT Pelayanan Sosial Lanjut Usia Binjai

ABSTRACT: FULFILLMENT OF URINE INCONTINENCE NEEDS FOR ELIMINATION WITH KEGEL EXERCISE AT BINJAI ELDERLY SOCIAL SERVICE UPT Background: Urinary incontinence means the spontaneous expulsion of urine at any time against the will (involuntary). Elderly is the process of slowly losing the ability of tissues to repair themselves/replace and maintain their normal function.Purpose: Kegel exercises are exercises to strengthen the pelvic muscles or exercises that aim to strengthen the pelvic floor muscles, especially the pubococcygeal muscles so that a woman can strengthen the urinary tract muscles.Methods: This research method is descriptive with a nursing process approach. The subject of the study was conducted on 2 patients with the same case, namely in patients who experienced urinary incontinence.Results: The results of the urinary incontinence assessment were associated with decreased bladder and detrusor muscle tone. The nursing interventions and implementation are monitoring the pattern and ability to urinate, identifying the causes of urinary incontinence, explaining the definition, types, and causes of urinary incontinence, recommending limiting fluid consumption 2-3 hours before bedtime, encouraging clients to do Kegel exercises and collaborating with medical and physiotherapists to overcome urinary incontinence. Kegel exercises were carried out in stages to the patient 2 days a day, morning and evening.Conclusion: The evaluation was carried out for 3 days and the results were that the patient was able to urinate and was controlled. The research is expected that the elderly UPT Binjai will improve more skills and always coordinate with other health teams in providing nursing care in accordance with Standard Operating Procedures (SOP). Keywords: Elimination Needs, Urinary Incontinence, Kegel Exercises INTISARI: PEMENUHAN KEBUTUHAN ELIMINASI PADA INKONTINENSIA URINEDENGAN KEGEL EXERCISE DI UPT PELAYANAN SOSIAL LANJUT USIA BINJAI Latar Belakang: Inkontinensia urin berarti pengeluaran urin secara spontan pada sembarang waktu diluar kehendak (involunter). Lansia adalah proses hilangnya secara perlahan-lahan kemampuan jaringan untuk memperbaiki diri/mengganti dan mempertahankan fungsi normalnya.Tujuan: Senam kegel adalah senam untuk menguatkan otot panggul atau senam yang bertujuan untuk memperkuat otot-otot dasar panggul terutama otot pubococcygeal sehingga seorang wanita dapat memperkuat otot-otot saluran kemih.Metode: Metode penelitian ini adalah deskriptif dengan pendekatan proses Keperawatan. Subjek penelitian dilakukan pada 2 orang pasien dengan kasu yang sama yaitu pada pasien yang mengalami inkontinensia urin.Hasil: Hasil pengkajian inkontinensia urin berhubungan dengan penurunan tonus kandung kemih dan otot detrusor. Intervensi dan implementasi keperawatanya itu memonitor pola dan kemampuan berkemih, mengidentifikasi penyebab inkontinensia urine, menjelaskan definisi, jenis dan penyebab inkontinensia urine, menganjurkan membatasi konsumsi cairan 2-3 jam menjelang tidur, menganjurkan klien untuk senam kegel dan melakukan kolaborasi dengan medis dan fisioterapi untuk mengatasi inkontinensia urine. Senam kegel dilakukan secara bertahap kepada pasien 2 hari sehari pagi dan sore hari.Kesimpulan: Evaluasi dilakukan selama 3 hari dan didapatkan hasil yaitu pasien dapat berkemih dan dikontrol. Penelitian diharapkan UPT lanjut usia Binjai meningkatkan keterampilan yang lebih dan selalu berkoordinasi dengan tim kesehatan lainnya dalam memberikan asuhan keperawatan sesuai dengan Standart Operasional Prosedur (SOP). Kata Kunci: Kebutuhan Eliminasi, InkontinensiaUrin, Senam Kegel

1242 A Surfacing Staghorn: Spontaneous Expulsion of a Large Renal Calculus from A Nephrocutaneous Fistula

An 83-year-old lady presented to the urology department with right flank pain in the context of a previously known right renal staghorn calculus. On examination, she was found to have a visible discharging sinus in her right flank, and the renal calculus had become visible at the skin surface. Non-contrast CT imaging confirmed that her staghorn calculus had eroded through the skin via a nephrocutaneous fistula. The stone was manually extracted percutaneously on the ward, and she was treated with intravenous antibiotics. She subsequently passed a further stone through the tract and made a good recovery. This is a highly unusual presentation of nephrolithiasis in a developed country in the 21st century. Review of the literature suggests that surgical management is almost always indicated in patients with staghorn calculi. However surgical management options are not without risk and conservative management of staghorn disease may be appropriate in select patient groups: those with multiple co-morbidities at high risk for GA, in cases of patient refusal of surgery, or in patients with aberrant anatomical factors Our case highlights a potential complication of conservatively managed staghorn stone disease. To our knowledge our case is the first of spontaneous expulsion of renal stone of this size to be reported in the developed world.